What radiographic feature is most characteristic of bronchiolitis on chest X-ray?

• A. Lobar consolidation
• B. Pleural effusion
• C. Pneumothorax
• D. Hyperinflation with peribronchial thickening; absence of focal consolidation

Answer: (D)

The radiographic hallmark of bronchiolitis is hyperinflation with peribronchial thickening and no focal consolidation. Viral inflammation of the small airways narrows bronchioles, causing air trapping that expands the lungs and yields increased lung volumes on X-ray. The thickened airway walls appear as prominent peribronchial markings. Because the process targets the bronchioles rather than the alveoli, you don’t see a dense, localized lobar consolidation. If imaging showed pleural effusion or pneumothorax, that would point to other conditions. Occasionally bronchiolitis may show mild atelectasis or be normal, but the classic pattern remains hyperinflation with peribronchial thickening and absence of focal consolidation.