We have chatted a couple of times about physical exam for COPD. As with all physical diagnoses, you should look for a variety of findings to support your diagnosis rather than relying on a single one. The key papers in COPD physical exam are the COAD1 and COAD2, authored by UofT's very own Dr. Sharon Straus.
Not surprisingly, smoking history and age, as well as reported COPD, predicted obstruction. In addition the phsyical exam findings on multivariate analyses supported maximum laryngeal height (<4cm), wheezing, forced expiratory time >9sec as being useful. Still look for the findings of barrel chest, laryngeal descent and tripodding, etc. As having multiple data points will increase your confidence. And remember, definitive diagnosis requires PFTs.
