The diffuse opacification seen on the chest x-ray of a neonate with respiratory distress syndrome primarily reflects

The diffuse opacification seen on the chest x-ray of a neonate with respiratory distress syndrome primarily reflects

• A. Pulmonary edema
• B. Pneumothorax
• C. Alveolar atelectasis
• D. Hyperinflation

Answer: (C)

In neonatal respiratory distress syndrome, lack of surfactant makes alveoli collapse and the lungs become under-aerated. This leads to diffuse, hazy opacities on the chest X-ray because many alveoli are collapsed or filled with fluid, giving a ground-glass appearance with low lung volumes. Air bronchograms may be seen because the airways remain open while surrounding alveoli are collapsed. This pattern is most consistent with alveolar atelectasis from surfactant deficiency. Pulmonary edema would usually show more vascular congestion and interstitial markings; a pneumothorax would show a visible pleural line with a portion of the lung collapsed away from the chest wall; hyperinflation would present with increased lung volumes and flattened diaphragms rather than diffuse poor aeration.

In neonatal respiratory distress syndrome, lack of surfactant makes alveoli collapse and the lungs become under-aerated. This leads to diffuse, hazy opacities on the chest X-ray because many alveoli are collapsed or filled with fluid, giving a ground-glass appearance with low lung volumes. Air bronchograms may be seen because the airways remain open while surrounding alveoli are collapsed. This pattern is most consistent with alveolar atelectasis from surfactant deficiency.

Pulmonary edema would usually show more vascular congestion and interstitial markings; a pneumothorax would show a visible pleural line with a portion of the lung collapsed away from the chest wall; hyperinflation would present with increased lung volumes and flattened diaphragms rather than diffuse poor aeration.