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Age: 18 months

Sex: Male

Indication: Respiratory distress

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Case #37


Findings

  • Pulmonary hyperexpansion with bilateral central interstitial thickening
  • No confluent airspace opacification
  • No pleural effusion or pneumothorax
  • Normal size and configuration of the cardiothymic silhouette


Diagnosis

  • Viral bronchiolitis

Sample Report

Pulmonary hyperexpansion with bilateral central interstitial thickening, which though nonspecific can be seen with viral bronchiolitis or reactive airways disease. No evidence of pneumonia.


Discussion

  • The hallmark of viral bronchiolitis in young children (< 2) is hyperinflation, which is usually accompanied by peribronchial thickening and scattered subsegmental atelectasis
  • As a general rule, there is hyperinflation if the lungs are expanded below the 6th anterior or 9th posterior rib on the frontal view. There should be flattening of the hemidiaphragms on both views



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