Infant with a fever

CXR and CT of diaphragm eventration — CXR PA and lateral (above) shows a right sided anteromedial opacity that obscures the right heart border on the PA image and the anterior portion of the right hemidiaphragm on the lateral image. Fluoroscopy showed the opacity to move synchronously with the diaphragm during normal respiration. Axial CT with contrast of the chest (below) shows the source of the opacity to be the liver positioned within the anteromedial lower right hemithorax.

The diagnosis was diaphragm eventration containing liver.

Former premature newborn who is now 6 years old with respiratory distress

Chest CT of bronchopulmonary dysplasia — Coronal CT without contrast of the lungs shows bilaterally increased interstitial lung markings and increased lung volumes along with an emphysematous bleb in the left lower lobe.

The diagnosis was bronchopulmonary dysplasia.

Former premature newborn who is now 7 months old with respiratory distress

CXR of bronchopulmonary dysplasia — CXR AP+lateral shows bilaterally increased interstitial lung markings and increased lung volumes along with emphysematous blebs in the left upper, left lower and right lower lobes.

The diagnosis was bronchopulmonary dysplasia.

Former premature newborn who is now 1 month old with respiratory distress on a ventilator

CXR of chronic lung disease — CXR AP shows increased interstitial lung markings bilaterally and normal lung volumes.

The diagnosis was chronic lung disease.

Premature newborn with respiratory distress syndrome and new abdominal distension on a ventilator

AXR of pneumoperitoneum in a patient with respiratory distress syndrome — CXR AP shows a bubbly branching appearance to the right lower lobe and overall increased lucency throughout the entire abdomen.

The diagnosis was pulmonary interstitial emphysema in the right lower lobe and pneumoperitoneum in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress syndrome and new abdominal distension on a ventilator

The diagnosis was pneumoperitoneum in a patient with respiratory distress syndrome.

Premature infant with respiratory distress on a ventilator

CXR of bilateral tension pneumothoraces and pneumomediastinum — CXR AP shows a large amount of lucency in the pleural spaces laterally and inferiorly to the right lung and superiorly and inferiorly to the left lung. There is air outlining the thymus and in the neck. The mediastinum remains in the midline.

The diagnosis was bilateral tension pneumothoraces and pneumomediastinum in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress on a ventilator

CXR of bilateral tension pneumothoraces in a patient with respiratory distress syndrome — CXR AP shows a large amount of lucency in the lung bases bilaterally while the cardiac silhouette is very narrow and small in size. The mediastinum remains in the midline.

The diagnosis was bilateral tension pneumothoraces confirmed after bilateral chest tube placement in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress on a ventilator

CXR of tension pneumothorax in patient with respiratory distress syndrome — CXR AP shows a large amount of lucency in the right pleural space and there is mediastinal shift to the left.

The diagnosis was a right tension pneumothorax in a patient with respiratory distress syndrome.

Premature infant with respiratory distress on a ventilator

CXR of pneumothorax in a patient with respiratory distress syndrome — CXR AP shows symmetrical ground glass appearance to the right lung and increased lucency throughout the left hemithorax with a suggestion of a left pleural edge laterally while the cross-table lateral CXR shows a large amount of lucency anterior to the heart.

The diagnosis was a large left anterior pneumothorax in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress on a ventilator

CXR of basilar pneumothorax in a patient with respiratory distress syndrome — CXR AP shows a large amount of lucency in the left lung base and over the left hemidiaphragm with a chest tube in the center of it.

The diagnosis was a basilar pneumothorax in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress on a ventilator

CXR of small bilateral pneumothoraces in patient with respiratory distress syndrome — CXR AP shows diffuse symmetrical ground glass opacity throughout the lungs along with increased lucency in the right lung base laterally and increased lucency distinctly outlining the left cardiomediastinal silhouette.

The diagnosis was bilateral small pneumothoraces which were confirmed with bilateral decubitus CXRs in a patient with respiratory distress syndrome.

Premature newborn on a ventilator

CXR of atelectasis in a patient with respiratory distress syndrome — CXR AP (above) shows symmetrical ground glass opacity in the lungs. CXR AP obtained after decreasing ventilator settings (below) shows interval decreased aeration of the right upper lobe.

The diagnosis was atelectasis caused by hypoventilation in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress on a ventilator

CXR of a pneumothorax and a skin fold simulating a pneumothorax in a patient with respiratory distress syndrome — CXR AP shows a small amount of increased lucency laterally in the right lung base and increased lucency in the left lung apex and base. There is also a straight line running at an angle across the lower lateral left chest.

The diagnosis was a right basilar pneumothorax and a large left pneumothorax and a skin fold in the lower lateral left chest which were confirmed with bilateral decubitus CXRs in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress on a ventilator

CXR of a skin fold simulating a pneumothorax in a patient with respiratory distress syndrome — CXR AP shows diffuse symmetrical ground glass opacity throughout the lungs and a straight line running at an angle across the lower lateral left chest.

The diagnosis was a skin fold in the lower lateral left chest and not a pneumothorax in a patient with respiratory distress syndome.

Premature newborn with respiratory distress on a ventilator

CXR of pneumomediastinum — CXR AP+lateral shows air around the thymus superiorly and air around the heart inferiorly. The diaphragm can be traced continuously across both images. There is also a small amount of air in the apex of the right pleural space.

The diagnosis was pneumomediastinum and a small right apical pneumothorax in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress on a ventilator

CXR of pulmonary interstitial emphysema — CXR AP shows a branching bubbly appearance to the right lung and a large amount of air in the right pleural space.

The diagnosis was pulmonary interstitial emphysema and tension pneumothorax in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress on a ventilator

The diagnosis was pulmonary interstitial emphysema in a patient with respiratory distress syndrome.

Premature newborn who has become more difficult to ventilate

The diagnosis was pulmonary interstitial emphysema and pneumomediastinum in a patient with respiratory distress syndrome.

Premature newborn who has received artificial surfactant

CXR of asymmetrical distribution of artificial surfactant in a patient with respiratory distress syndrome — CXR AP obtained just after birth (left) shows the lungs to be hypoexpanded with symmetrical ground glass opacity present throughout the lungs from their apex to their base. CXR AP taken after the administration of artificial surfactant (right) shows the right lung to now be normally expanded with clearing of the previously seen ground glass opacity while the left lung remains hypoexpanded with asymmetrical ground glass opacity present throughout it.

The diagnosis was asymmetrical distribution of artificial surfactant in a patient with respiratory distress syndrome.

Premature newborn who has received artificial surfactant

The diagnosis was symmetrical distribution of artificial surfactant in a patient with respiratory distress syndrome.

Premature newborn with respiratory distress

CXR of respiratory distress syndrome / surfactant deficiency disorder — CXR AP shows the lungs to be hypoexpanded with symmetrical ground glass opacity present throughout the lungs from their apex to their base.

The diagnosis was respiratory distress syndrome.

Teenager with a chest wall deformity

Clinical image of pectus excavatum — Clinical image shows a marked concavity of the chest wall.

The diagnosis was pectus excavatum.

Toddler who was seen ingesting gasoline

CXR of lipoid pneumonia — CXR AP obtained 1 week after the ingestion of gasoline shows bilateral perihilar confluent infiltrates. No pneumatocele is seen.

The diagnosis was lipoid pneumonia.

Toddler who was seen ingesting kerosene

The diagnosis was lipoid pneumonia.