Radiographic Thoracic Cage Parameters as Indicators of Pulmonary Dysfunction in COPD: A Clinical Study

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive disorder marked by irreversible airflow limitation and structural lung changes. Radiographic thoracic cage alterations such as increased anteroposterior diameter, diaphragmatic flattening, and rib horizontalization reflect underlying hyperinflation and impaired respiratory mechanics. Assessing these simple radiographic parameters may help predict pulmonary dysfunction. This study evaluates the association between thoracic cage morphology and COPD severity among patients in a clinical setting. Objectives: To assess radiographic thoracic cage parameters and determine their association with pulmonary dysfunction and disease severity in clinically diagnosed COPD patients. Materials and Methods: This cross-sectional study was conducted at the Respiratory Medicine Department, Dhaka National Medical College and Hospital, from June 2024 to May 2025, including 146 COPD patients. Data on demographics, smoking history, radiographic thoracic cage parameters, and spirometry results were collected. Standardized chest radiographs and pulmonary function tests were performed. Data were analyzed using SPSS 26, applying descriptive statistics and chi-square tests. Ethical approval and informed consent were obtained. Result: The study included 146 COPD patients with a mean age of 62.1 ± 8.7 years; 38.4% were aged 60–69, and 69.9% were male. Increased AP diameter was found in 50.7%, horizontal ribs in 61%, and diaphragmatic flattening in 65.8%. Severe and very severe obstruction occurred in 37.7% and 26%, respectively. Biomass exposure affected 59.6%, while 37% had 2–3 exacerbations and 21.9% had ≥4 in the past year. Conclusion: Radiographic thoracic cage changes strongly correlate with COPD severity, indicating that simple chest radiographs can effectively reflect underlying pulmonary dysfunction. Medicine Today 2026, Vol.38 (2): 218-222