A butterfly pattern or batwing pattern on a chest radiograph indicates?

A butterfly pattern or batwing pattern on a chest radiograph indicates?

• A. Pneumonia
• B. Atelectasis
• C. ARDS
• D. Pulmonary edema

Answer: (D)

A butterfly or bat-wing pattern on a chest radiograph signals central interstitial edema from elevated pulmonary venous pressure, typically due to left-sided heart failure. The fluid accumulates around the hila and spreads outward into the perihilar and lower lung zones, creating symmetric opacities that resemble wings. This central distribution is the hallmark of pulmonary edema, reflecting fluid leaking into the interstitium and, as it worsens, into the alveoli. Pneumonia usually presents as focal or lobar consolidation rather than a symmetric perihilar pattern. Atelectasis tends to produce linear or plate-like opacities at the bases or in dependent regions rather than a central bat-wing distribution. ARDS can cause diffuse bilateral infiltrates, but the classic bat-wing pattern is most characteristic of cardiogenic pulmonary edema due to congestive heart failure.

A butterfly or bat-wing pattern on a chest radiograph signals central interstitial edema from elevated pulmonary venous pressure, typically due to left-sided heart failure. The fluid accumulates around the hila and spreads outward into the perihilar and lower lung zones, creating symmetric opacities that resemble wings. This central distribution is the hallmark of pulmonary edema, reflecting fluid leaking into the interstitium and, as it worsens, into the alveoli.

Pneumonia usually presents as focal or lobar consolidation rather than a symmetric perihilar pattern. Atelectasis tends to produce linear or plate-like opacities at the bases or in dependent regions rather than a central bat-wing distribution. ARDS can cause diffuse bilateral infiltrates, but the classic bat-wing pattern is most characteristic of cardiogenic pulmonary edema due to congestive heart failure.