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Flattening of the diaphragm

Flattening of the diaphragm is the most sensitive sign on chest radiographs for the presence of hyperinflation of the lungs, usually due to emphysema 1-2.

The normal dome of each hemidiaphragm should rise at least 1.5cm above a line connecting the costophrenic angle posteriorly and sternophrenic angle anteriorly 1.

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