In acute respiratory distress syndrome (ARDS), what is the typical initial chest radiograph finding?

In acute respiratory distress syndrome (ARDS), what is the typical initial chest radiograph finding?

• A. Bilateral diffuse opacities
• B. Lobar consolidation
• C. Normal chest radiograph
• D. Cavitation

Answer: (A)

ARDS causes diffuse, noncardiogenic pulmonary edema from widespread capillary leak, so the initial chest radiograph typically shows bilateral, diffuse opacities in both lungs. The heart size is usually normal because the edema isn’t due to heart failure. This pattern distinguishes ARDS from a focal process like lobar consolidation, from cavitation seen with necrotizing infections or TB, and from a normal radiograph which is uncommon once ARDS has begun.

ARDS causes diffuse, noncardiogenic pulmonary edema from widespread capillary leak, so the initial chest radiograph typically shows bilateral, diffuse opacities in both lungs. The heart size is usually normal because the edema isn’t due to heart failure. This pattern distinguishes ARDS from a focal process like lobar consolidation, from cavitation seen with necrotizing infections or TB, and from a normal radiograph which is uncommon once ARDS has begun.