In COPD, which radiographic finding is commonly seen besides hyperinflation?

• A. Hyperinflation
• B. Flattened diaphragms
• C. Elevated diaphragms
• D. Normal diaphragms

Answer: (B)

In COPD, especially emphysema, air trapping expands the lungs and increases overall lung volume. That excess expansion pushes the diaphragms downward and stretches them out, so they lose their normal dome shape and become flattened. This diaphragmatic flattening is a classic accompanying radiographic sign of hyperinflation, reflecting the lung overdistention that COPD causes. On X-ray you may also notice the lungs look more lucent and the retrosternal airspace may be increased, but the key point is the diaphragms’ flattened, more horizontal appearance.