Diagnosing Chronic Obstructive Lung Disease

(Page 3)

Click the icon to see an image of lung diffusion testing.

Imaging Tests

Chest X-Rays. Chest x-rays are often performed, but they are not very useful for detecting early COLD. By the time an x-ray reveals the disease, the patient is well aware of the condition.

Clear signs of emphysema include the following:

• A flattened diaphragm
• Exaggerated lung inflation in upper areas
• Abnormally large amounts of air spaces in the lung
• A smaller heart; if heart failure is present, however, the heart size becomes normal and signs of overinflated lungs are not present.
• A1AD-related emphysema patients show larger amounts of air in the lower lungs

Chest x-rays are rarely useful for diagnosing chronic bronchitis, although they sometimes show mild scarring and thickened airway walls.

Computed Tomography. Computed tomography (CT) scans can accurately assess the severity of COLD and may be used to determine the size of the air pockets (bullae) in the lungs. This imaging technique may even be useful for assessing mild COLD.

Other Tests for Chronic Obstructive Lung Disease

Noninvasive Methods for Determining Severity. Questionnaires and short exercise tests are very useful for determining the severity of COLD.

Test for ATT. Physicians will typically test for the protective enzyme, alpha 1-antiprotease (ATT or antitrypsin), which is often deficient in COLD patients (although asthma patients may also have low levels).

Additional Blood and Sputum Tests. Additional tests may be required if the physician suspects other medical problems. If pneumonia is present, for instance, blood and sputum tests and cultures may be performed to determine the cause of infection.

Review Date: 04/28/2006
Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital