Chest X-Ray

A chest X-ray provides two kinds of information, depending on whether it is taken in the absence of complications, or during one. Without active complications, it shows only the changes caused by chronic chest hyperinflation which can occur in all forms of COPD. The normally dome-shaped diaphragm is quite flattened. Some experts find a flattened diaphragm so universal in their emphysema patients that they consider its presence to be unquestionable diagnostic proof. Because emphysema is the one form of COPD involving actual tissue destruction very early on, the X-ray of a patient with emphysematous changes is also highly translucent and the lungs' blood vessels are no longer clearly visible.

When a respiratory complication exists, an X-ray can confirm its nature: pneumonia; local areas of airless lung tissue (called atelectasis) due to mucus plugging; the accumulation of air between layers of the thin sheath of tissue covering the lungs (a condition called bleb); the collapse of large tissue areas from air seeping in between the lungs and chest wall (called pneumothorax); the presence of large air-containing spaces (termed bullae) resulting from emphysema's destruction, enlargement, and merging of air sacs.

The X-ray can also show cardiac involvement in the disease process. The heart