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Chest X-Ray

Lung Inflation

February 15th, 2021


Normally, six anterior ribs and nine posterior ribs should be seen above the diaphragm.


  • Look For

  • Hyperlucency of the lung fields
  • Diaphragmatic flattening
  • Ten or more posterior ribs visible above the diaphragm
  • Mediastinal narrowing
  • Example

  • Hyperinflation in a patient with emphysema
  • Hyperinflation in a patient with emphysema
  • Significance

  • Hyperinflation is a sign of emphysema, though can rarely occur with other obstructive diseases such as asthma and bronchiectasis.


  • Look For

  • Less than eight posterior ribs visible above the diaphragm.
  • Causes of Underinflation

  • Poor inspiratory effort
  • Restrictive lung disease
  • Atelectasis
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