
Note the clusters of dilated air spaces which are conspicuous in the middle and lower lobes of the right lung and the lower lobe of the left lung. Both lungs are markedly enlarged.	Normal lungs

Hyperinflation is the common finding in all three conditions presenting as COPD.
- Low set diaphragm
- Flat diaphragm best determined by lateral chest
- Hyper lucent lung fields
- Increased AP diameter
- Increased retro-sternal air
- Vertical heart
Asthma, chronic bronchitis and dmphysema are usually indistinguishable by CXR. Only when you see bullae and avascularity in the peripheral third of lung you can consider emphysema.

Q3: What are the x-ray findings of emphysema?
	Lungs are large and hyperinflated. Signs of hyperinflation are low set diaphragm, increased AP diameter, vertical heart and increased retrosternal air. Signs of hyperinflation can be seen in emphysema, chronic bronchitis and asthma. We can call it emphysema only when hyperinflation is associated with blebs and paucity of vascular markings in the outer third of the film.
	Lateral chest is best to evaluate flattening of diaphragm, AP diameter and retrosternal air.