Follow-up x-ray in patients with COPD

Should we perform repeated follow-up x-ray examinations in patients with chronic obstructive pulmonary disease (COPD)? If yes, when should they be scheduled?

Julian Dobranowski, MD: In a patient that has a chronic diagnosis of COPD, you really do not require any type of examination unless there is an exacerbation of symptoms. In that situation you would do a chest x-ray and [proceed] depending on what the findings are. If the patient has community-based pneumonia, then you would follow up that patient in an appropriate period of time. Guidelines are talking about a 6-week follow-up on these patients. Of course if the patient gets worse, then you would shorten that interval period but noncomplicated COPD does not require any imaging.