Greene used a radiographic index to describe changes seen in the chest X-ray of a patient with chronic obstructive pulmonary disease (COPD). The author is from Massachusetts General Hospital.
Parameters:
(1) diaphragmatic level
(2) anterior bowing of the sternum on the lateral view
(3) aerated lung visible below the cardiac silhouette on the PA view
(4) pulmonary vascular attenuation
(5) bullous lung disease
Parameter
Finding
Points
diaphragmatic level
normal
0
depressed
1
anterior bowing of the sternum
absent
0
present
1
aerated lung below the cardiac silhouette
absent
0
present
1
vascular attenuation
absent
0
present
1
bullous lung disease
absent or indeterminate
0
definite
1
COPD index =
= SUM(points for all 5 findings)
Interpretation:
• minimum index: 0
• maximum index: 5
• A score >= 2 was considered significant radiologic evidence of COPD.
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