Which chest X-ray finding is typical of emphysema?

• A. Lobar consolidation
• B. Hyperinflation with flattened diaphragms
• C. Pleural effusion
• D. Normal chest radiograph

Answer: (B)

Emphysema causes air trapping and loss of elastic recoil, which makes the lungs chronically overinflated. On a chest X-ray this shows up as hyperinflation with flattened diaphragms because the lungs are expanded and push the diaphragms downward and outward. This pattern reflects the increased lung volumes that occur with emphysema.

Lobar consolidation would appear as a localized white opacity in a lobe, consistent with pneumonia, not the diffuse overinflation seen in emphysema. Pleural effusion shows fluid accumulating in the pleural space, leading to blunting of the costophrenic angles and possibly mediastinal shift if large, not flattened diaphragms from hyperinflation. A normal chest radiograph can occur in mild disease, but the typical, characteristic finding in established emphysema is hyperinflation with flattened diaphragms.