In meconium aspiration syndrome, which radiographic pattern is characteristic?

• A. Normal radiograph
• B. Diffuse haziness and increased pulmonary vascular markings
• C. Reticulogranular pattern with air bronchograms
• D. Overinflation, coarse irregular densities and diminished aeration

Answer: (D)

Meconium aspiration leads to airway obstruction and air trapping, producing hyperinflation with patchy areas of atelectasis and meconium-filled airways. On chest radiographs this shows up as overinflated lungs with coarse, irregular densities and regions of diminished aeration. This pattern—air trapping with uneven, coarse densities—is characteristic of MAS.

Other patterns fit different conditions: a reticulogranular pattern with air bronchograms is classic for respiratory distress syndrome in preterm infants, diffuse haziness with increased vascular markings suggests edema or infection, and a normal radiograph would not reflect MAS.