Surfactant deficiency disease, also called hyaline membrane disease or idiopathic respiratory distress syndrome, is the most common cause of respiratory distress in the newborn infants [1]. It occurs in premature infants and also infants with diabetic mothers. The basic pathophysiology of this disease is a deficiency of pulmonary surfactant superimposed on structural immaturity of the lungs. Without surfactant, the alveolar surface tension is elevated, causing collapse of alveoli [2]. There is also overdistention of the terminal bronchioles and terminal air sacs.
        The radiographic findings in surfactant deficiency disease are small lung volume, a finely granular (ground glass) appearance of the lung parenchyma, and air bronchograms extending peripherally [1,3].

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.Figure 1. Note diffuse granularity of the lungs and air bronchograms.
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