Pediatric Asthma

  • Etiology: chronic inflammation of airways, restricted air flow due to smooth muscle constriction / airway wall edema / intra-luminal mucous accumulation, can be sequelae of respiratory syncytial virus infection
  • Imaging: airway thickening, hyperinflation due to ball-valve effect, shifting subsegmental atelectasis from mucous plugs, pulmonary artery constriction
  • DDX: viral pneumonia, congenital heart disease
  • Complications: pneumomediastinum is rare, pneumothorax is rare, pulmonary edema

Radiology Cases of Asthma

CXR of cardiogenic pulmonary edema in asthma
CXR AP (left) shows cardiomegaly and bilateral perihilar interstitial infiltrates due to pulmonary vascular congestion. CXR AP (right) obtained after resolution of symptoms shows the heart and pulmonary vascularity to be normal in appearance while the airways are thickened and the lungs are hyperexpanded.
CT of asthma
Axial CT without contrast of the chest shows bilateral bronchial wall thickening and streaky atelectasis in the lingula and right middle lobe and differential aeration of the pulmonary segments.