Value of chest radiographs in severe acute asthma

Chest radiographs were obtained in 117 adults admitted with severe acute asthma. In 10 (9%) patients abnormalities were seen that affected management and in nine the presence of pulmonary collapse or consolidation was shown which was not detected by clinical examinations. Over-inflation was common and correlated significantly with tachycardia, pulsus paradoxus and decrease in FEV1. Bronchial wall thickening was common and prominence of hilar vessels was also noted in a few patients. Chest radiography is strongly recommended in severe exacerbation of asthma and antero-posterior views are adequate for interpretation.