What does a chest X-ray typically show in respiratory distress syndrome?

In cases of respiratory distress syndrome (RDS), which primarily affects premature infants due to surfactant deficiency, a chest X-ray typically reveals low lung volumes accompanied by a diffuse reticulogranular pattern. This pattern reflects the presence of atelectasis—collapse of lung tissue—and the resultant ground-glass opacities seen in the lungs. The reticular aspect is indicative of the edema and the alveolar collapse that occurs due to insufficient surfactant, which normally helps to keep the alveoli open.

This characteristic appearance helps differentiate RDS from other respiratory conditions, as the low lung volumes and reticular granularity are specific findings associated with the alveolar instability and fluid collections inherent to this syndrome. The other options, while representing possible findings in different lung conditions, do not accurately describe the typical radiographic appearance seen in RDS. For instance, fluid accumulation in the lungs would suggest pulmonary edema rather than the specific changes seen in RDS, while high lung volumes with clear fields might indicate healthy lungs or hyperinflation, not the collapse observed in RDS. Consolidation in one lobe is indicative of pneumonia or other localized infections rather than the diffuse involvement seen in this syndrome.