Criteria are put forward for the recognition and assessment of radiographic abnormalities in childhood asthma. Using these criteria, radiographs of the chest in 218 children with asthma are compared with those of 162 normal children. In 73% of the asthmatic children the radiograph appeared to be normal, 15% presented a simple overinflation pattern with long narrow lungs and a narrow vertical heart (0-1 pattern), and 12% showed the same pattern together with enlargement of the hilar vessels relative to the lung vessels (0-2 pattern). Those children with the most marked radiographic abnormalities (0-2 pattern) were, without exception, suffering from severe or moderately severe constant asthma. Those with intermittent symptoms usually had radiographs which appeared to be normal even during their asthmatic episodes.
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