A 3-year-old child with recurrent respiratory infections has a chest X-ray showing hyperinflation, increased bronchovascular markings, and peribronchial thickening with tram-track opacities. The most likely diagnosis is:
- A Cystic fibrosis
- B Bronchiectasis ✓
- C Primary ciliary dyskinesia
- D Asthma
Correct answer: B. Bronchiectasis
Explanation
The tram-track opacities represent thickened and dilated bronchial walls, the hallmark of bronchiectasis. While cystic fibrosis commonly causes bronchiectasis, the question asks for the radiological finding. Bronchiectasis is the diagnosis that directly explains the tram-track appearance. Asthma does not cause tram-track opacities. Primary ciliary dyskinesia can cause bronchiectasis but is a specific etiology rather than the radiological diagnosis itself.
Reference: Caffey's Pediatric Diagnostic Imaging, 12th ed.
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