The goal of a new study published in BMC Pulmonary Medicine was to review CT findings of a local cohort of children with severe asthma and to explore whether clinical or pathobiological parameters predicted CT changes. This was a retrospective observational single center study, that enrolled all children attending the Leicester difficult asthma clinic (DAC) who underwent a chest CT from 2006-2011. In addition, eight age-matched, non-asthmatic controls were also included, to compare differences in CT findings between asthmatic and non-asthmatic children. All CT images were independently scored by two radiologists. The 30 DAC patients (age-range 5-16 years) were sub-divided into binary groups for each abnormality identified so that comparisons could be made against recorded clinical variables including age, lung function, serum total IgE levels and sputum leukocyte differential cell counts. The results showed that the most common abnormalities were bronchial wall thickening (BWT) and air trapping (AT), observed in 80 and 60% of DAC patients. Bronchiectasis (BE) was identified in 27% of DAC patients. DAC patients with evidence of BE on CT images were older than those without BE. A positive correlation between increasing BE severity and extent with age was identified. Hence, abnormal CT findings were highly prevalent in our cohort of children with severe asthma, bronchiectasis being identified in approximately one third of children. It was inferred that an alternative diagnosis did not result in a change in the clinical management.