What radiographic finding is commonly seen in COPD?

• A. Hyperinflation with flattened diaphragm
• B. Consolidation in lobes
• C. Large pleural effusion
• D. Normal chest

Answer: (C)

The key radiographic pattern in COPD is hyperinflation from air trapping, which causes the diaphragms to flatten. Chronic airway obstruction—whether from emphysema or chronic bronchitis—prevents complete exhalation, so the lungs stay enlarged and push the diaphragms downward, giving a low, flattened appearance on a chest X-ray. You may also see an increased retrosternal airspace on the lateral view and bibasilar atelectasis or bullae in emphysema. Consolidation would point toward infection, a large pleural effusion would blur or blunt the costophrenic angles and reduce rather than reflect hyperinflation, and a normal chest would not show the characteristic hyperinflation of COPD.