COPD Diagnosis Print How Chest X-Rays Can Help Diagnose COPD Written by Written by Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. Learn about our editorial policy Deborah Leader, RN Updated on June 24, 2019 COPD Overview Symptoms Causes Diagnosis Treatment Coping Caregiving REB Images/Getty Images If your doctor suspects you have chronic obstructive pulmonary disease (COPD), you will be likely be asked to have a chest X-ray. A chest X-ray is a simple, non-invasive imaging technique that uses electromagnetic waves to create a one-dimensional picture of your heart, lungs, and diaphragm. While a chest X-ray cannot make a diagnosis of COPD, especially in early-stage disease, it can help support it. By and large, an abnormal chest X-ray is generally only seen when the damage to the lungs is extensive. What a Chest X-Ray Can Tell Us In early-stage disease, a chest X-ray may, in fact, appear quite normal. This doesn't mean that there is no damage; it is simply that the test has limitations as to how much it can visually tell us. It can neither describe your individual lung capacity nor the force by which you can inhale or exhale air. What it can do is give us a visual reference point by which to compare any changes that may develop over time. As such, doctors will typically recommend a chest X-ray every one or two years depending on how far along your COPD is. In later-stage disease, visual changes will become more apparent. One of the most obvious features will be the so-called hyperinflation of the lungs. When this happens, the doctor will be able to see several things on the X-ray: A flattening of the diaphragm as the lungs press down on the muscleIncreased chest size as measured from front to backAn elongated and narrow heartPockets of air called bullae around a half inch in size or larger In the event your doctor needs a more extensive view of the lung structure and damage, a computed tomography (CT) scan may be ordered. Where a chest X-ray will only deliver a one-dimensional image of the lungs, a CT scan will take a series of images to create a more three-dimensional representation. In doing so, the CT scan can pick up finer detail and provide doctors a more complete portrait of the person's COPD. How COPD Is Diagnosed To make an accurate diagnosis of COPD, a comprehensive evaluation would be performed to provide a baseline assessment of your current health, your family history, your smoking status, and any environmental or occupational toxins you may have been exposed to. In addition to a chest X-ray, you may be asked to undergo one or several of the following tests: Arterial blood gasses to determine how much oxygen and CO2 is in your bloodPulmonary function tests to measure how well your lungs inhale and exhale and how efficiently they transfer oxygen to the bloodBronchoscopy using a flexible, lighted scope to visually examine the lungPulse oximetry to measure the oxygen saturation in your bloodSix-minute walk test to assess your respiratory response to exerciseAAT deficiency screening to determine whether there is a lack of the alpha-1 anti-trypsin (AAT) protein which helps protect the lungs and liver If a positive diagnosis is returned, your doctor would next determine the stage of your disease and design a treatment plan to help slow the progression of COPD. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Vogelmeier, C.; Criner, G.; Martinez, F. et al. "Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary." American Journal of Respiratory and Critical Care Management. 2017; 195(5):DOI 10.1164/rccm.201701-0218PP. Continue Reading