What is the role of radiography in the diagnosis of emphysema?

Updated: Mar 13, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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In clinical practice, reliance is placed on the patient's history, lung function, and abnormal chest radiographs to diagnose emphysema. Chest radiographic findings generally cannot establish the diagnosis of mild emphysema; however, when emphysema is fully established, classic radiographic findings are typically observed. Findings on routine chest radiographs can suggest emphysema, but this is not a sensitive technique for diagnosis. However, chest radiography is useful to look for complications during acute exacerbations and to exclude other pathologies, such as superadded infection or lung cancer.

The chest radiograph is not a good indicator of the severity of disease and does not help in identifying patients with COPD without significant emphysema. Thurlbeck and Simon found that only 41% of those with moderately severe emphysema and two thirds of those with severe emphysema had evidence of disease on chest radiography. [15]

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