Transient tachypnoea of the newborn typically shows which chest radiograph finding within 2 hours of birth?

• A. Hyperexpansion with perihilar densities and fluid within fissures
• B. Diffuse reticulonodular pattern
• C. Normal chest radiograph
• D. Large pleural effusions

Answer: (A)

Transient tachypnea of the newborn happens when fetal lung fluid clearance is delayed, leading to mild interstitial edema and some air trapping. In the first hours after birth, the chest radiograph typically shows lungs that are hyperexpanded with prominent central (perihilar) markings, and fluid can be seen outlining the fissures, especially the horizontal fissure. This combination—increased lung volumes with perihilar densities and fissural fluid—is the classic early imaging pattern for TTN and helps distinguish it from other neonatal lung conditions.

Other patterns are less typical for TTN in this early window: a diffuse reticulonodular appearance can point toward different etiologies like infection or surfactant issues; a normal radiograph is less likely given the fluid overload; and large pleural effusions suggest alternative problems such as hydrops or other pathology.