• Note the clusters of dilated air spaces which are conspicuous in the middle and lower lobes of the right lung and the lower lobe of the left lung.
  • Both lungs are markedly enlarged.
Normal lungs
Q1: What are the conditions that present as COPD?
Q2: What are the anticipated findings of COPD in CXR?
Q3: What are the x-ray findings of emphysema?
  • Lungs are large and hyperinflated.
  • Signs of hyperinflation are low set diaphragm, increased AP diameter, vertical heart and increased retrosternal air.
  • Signs of hyperinflation can be seen in emphysema, chronic bronchitis and asthma. We can call it emphysema only when hyperinflation is associated with blebs and paucity of vascular markings in the outer third of the film.
Lateral chest is best to evaluate flattening of diaphragm, AP diameter and retrosternal air.