I disagree.
Symptoms of rhizosphaera are most prominent on older needles.
Healthy Pines hold there needles for 3 years. When they get rhizosphaera, there will only be one or two year old needles left on the tree, and the tree starts to look sparse.
It takes time for the fungus to kill the needles, so the new growth looks the best and the one and two year old needles needles eventually die and fall off.
Often, the tree will grow for years with the fungus.
"Because of the long delay between infection in spring and needle drop the following summer, the ends of infected branches appear green and healthy. Branches appear to lose their needles from the trunk outward. Those branches which repeatedly lose needles for three or four years may die."
Source of above quote.