Q. The Accuracy of Chest X Rays in Diagnosing Emphysema
My question involves a chest x-ray and the diagnosis of emphysema. It appears from the medical literature that a chest x-ray can be used to diagnose moderate to severe emphysema but is not very useful in cases involving early or mild emphysema. Can you share your thoughts on this ? Some of the radiology sites that I have visited conclude that lung changes are visible on standard x rays for certain stages of emphysema and even chronic bronchitis. It is difficult to find a consensus however. Thank you. John
A. Hi John,
Indeed, chest x-rays can show lung changes of chronic bronchitis and emphysema. BUT, what they show cannot be used to “quantify” one’s disease, or assign severity. CT scans, as radiological studies are VERY sensitive to identify changes associated with COPD and the specific ailments under that umbrella, among other types of lung conditions. But, THEY cannot adequately correlate to “clinical condition and severity”. PFT’s are the most sensitive to correlate with clinical severity and even they are not ‘sure-fire’. BUT, combine PFT’s with clinical complaints and symptoms as well as a well-done walk test, and you have perhaps the best combination of information you need to effectively classify someone AND to treat them optimally. CT’s and chest x-rays are helpful “after” those I just mentioned to round out the whole picture. My 40 years dealing with all these modes and mediums has brought me to that position.
Mark Mangus, Sr. BSRC, RRT, RPFT, FAARC