What to Expect From COPD Chest X-Rays

What to Expect From COPD Chest X-Rays

Why Am I Getting COPD Chest X-Rays?

If you have chronic obstructive pulmonary disease (COPD), you may wonder why your doctor occasionally asks for an X-ray of your chest.

Generally speaking, chest X-rays are recommended early on, when the initial COPD diagnosis is made. An X-ray is great for evaluating your heart and lungs, but can’t confirm the diagnosis of COPD on its own. It can, however, be used in addition to other tests when COPD is suspected, because it can rule out other conditions like lung cancer, heart failure, pneumonia or tuberculosis. Your doctor can also evaluate the shortness of breath and the severity of emphysema when looking at the X-ray.

After Diagnosis

After diagnosis, a doctor may request a chest X-ray every couple of years, especially in smokers and ex-smokers or during an acute episode of COPD. If you are in the early stages of COPD, what appears on the X-ray may be normal.

However, as the disease progresses, it may show changes associated with COPD. These include:

  • Flattening of the diaphragm, the large muscle that separates the organs from thorax from abdomen.
  • Increased size of the chest, measured from front to back, also known as barrel-shaped chest.
  • Changes in heart shape, usually the heart becomes long and narrow.
  • Excessive air in the lungs — abnormal collections of air in the lungs medically known as focal bullae.

A chest X-ray may be ordered (along with other investigations) during an acute exacerbation of COPD, when the condition is complicated with fever or significant distress, if the patient has heart or other lung diseases, when seizures are present, in case of IV drug abuse, or before surgery.


High resolution CT scans may also be used, as they are more accurate to evaluate emphysema as well as the need for surgery in some COPD patients. This test can also suggest the alpha-1 antitrypsin deficiency, as condition that increases the chance to develop COPD.

What to Expect from COPD Chest X-Rays

Your body will be positioned between the X-ray machine and a plate. You will be asked to move in different positions, so the X-ray technician can take views from different angles. During the front view, remember to stand against the plate, hold your arms up (or to the side), roll your shoulder forward and take deep breaths when you are asked to — this way the image will be clearer.

Keep a copy of all the chest X-rays you have done. By comparing older tests with a new one, a doctor can better assess how your lungs are working and adjust your treatment as necessary.


Web MD (Chest X-Rays for COPD)

Medscape (COPD)

EB Medicine (Acute Exacerbations Of COPD: A Practical Approach To Differential Diagnosis And Management)

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