DDX of Bell-Shaped (Small) Chest in Neonates

Approach to the DDX of a bell-shaped (small) chest in neonates:

  • Oligohydramnios – due to pulmonary hypoplasia
  • Respiratory distress syndrome – due to pulmonary hypoexpansion
  • Neuromuscular paralysis – due to hypotonia causing body wall edema
  • Hydrops fetalis – due to third spacing causing body wall edema
  • Asphyxiating thoracic dystrophy / Jeune’s Syndrome – due to short ribs
  • Thanatophoric dysplasia – due to short ribs and platyspondyly