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Currie and Legge are right to say that a chest x-ray is the best first
line imaging test for patients with suspected COPD. (1) But they don’t
point out the limitations of a plain x-ray. Chest x-rays are usually
abnormal in patients with severe COPD but they may not show suggested
changes in up to 40 % of patients with mild or moderate disease. (2) You
should not exclude the diagnosis on the basis of a normal chest x-ray
Dr Sarah Farrow.
1. Currie GP. Legge JS. ABC of chronic obstructive pulmonary
disease: Diagnosis BMJ 2006;332:1261-1263
2. Muller NL, Coxson H. Chronic obstructive pulmonary disease. 4:
imaging the lungs in patients with chronic obstructive pulmonary disease.