A 34-week premature neonate develops respiratory distress within the first hour of life. Chest X-ray shows diffuse granular opacities with air bronchograms in both lung fields and reduced lung volumes. Which of the following is the most likely diagnosis?
- A Transient tachypnea of the newborn
- B Neonatal pneumonia
- C Hyaline membrane disease ✓
- D Meconium aspiration syndrome
Correct answer: C. Hyaline membrane disease
Explanation
Hyaline membrane disease (respiratory distress syndrome) classically shows diffuse fine granular or ground-glass opacities with air bronchograms and low lung volumes due to surfactant deficiency. Transient tachypnea of the newborn shows hyperinflation and fluid in fissures. Meconium aspiration shows patchy infiltrates with hyperinflation. Pneumonia can mimic HMD but low lung volumes favor surfactant deficiency.
Reference: Caffey's Pediatric Diagnostic Imaging, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.