What radiographic pattern is characteristic of neonatal respiratory distress syndrome?

• A. Lobar consolidation
• B. Diffuse hazy reticulogranular pattern with air bronchograms
• C. Pleural effusion
• D. Hyperinflation with atelectasis

Answer: (B)

This pattern reflects surfactant deficiency causing widespread collapse of alveoli in the newborn. On radiographs, the lungs look diffusely hazy with a fine reticulogranular or ground-glass appearance, and the airways remain visible as air bronchograms because the surrounding collapsed alveoli make the bronchi stand out. The overall look is underinflated, often bilateral and symmetrical, with diaphragms relatively high due to lung volume loss. This combination—diffuse hazy reticulogranular density with air bronchograms—is the classic radiographic sign of neonatal respiratory distress syndrome. Lobar consolidation would be a focal dense area in one lobe, pleural effusion would show fluid collections and blunted angles, and hyperinflation with atelectasis would not match the uniform, low-volume, ground-glass pattern seen here.