Which radiographic finding is typical of transient tachypnea of the newborn?

• A. Diffuse reticulonodular pattern.
• B. Lobar consolidation.
• C. Hyperinflation without central markings.
• D. Central perihilar markings with mild hyperinflation.

Answer: (D)

Transient tachypnea of the newborn results from delayed clearance of fetal lung fluid, leading to mild interstitial edema and fluid around the airways. On chest radiographs, the hallmark is mild hyperinflation with prominent central perihilar markings. The central markings reflect edema and vascular congestion near the hila, while the mild hyperinflation results from some air trapping as the airways are affected by the fluid. You may also see slight atelectasis at the bases as the lungs gradually clear.

This pattern helps distinguish TTN from other newborn respiratory conditions. A diffuse reticulonodular pattern is more typical of respiratory distress syndrome due to surfactant deficiency. Lobar consolidation points to focal bacterial pneumonia. Hyperinflation without central markings can occur with bronchiolitis or other causes of airway inflammation, but TTN traditionally shows those central perihilar markings paired with mild hyperinflation.