Sinusitis and chronic cough in children.

Area of Science:

• Pediatric Pulmonology
• Pediatric Radiology
• Medical Diagnostics

Background:

• Chronic cough is a frequent pediatric concern, often linked to sinusitis.
• Diagnosing sinusitis in children typically relies on clinical assessment, with CT scans often preferred over sinus X-rays for confirmation.

Purpose of the Study:

• To determine the prevalence of abnormal sinus X-rays in children experiencing chronic cough (>4 weeks).
• To compare sinus X-ray interpretations between allergy/pulmonary specialists and radiologists.
• To correlate clinical symptoms with X-ray findings in pediatric chronic cough cases.

Main Methods:

• A retrospective chart review was conducted on 86 pediatric patients (ages 2-18) with cough duration exceeding 4 weeks.
• Data included clinical evaluations, Water's view sinus X-ray results, and patient outcomes.
• Statistical analyses were performed to assess associations between symptoms and X-ray findings.

Main Results:

• Clinicians identified abnormal sinus X-rays in 65% of cases, closely aligning with radiologists' findings (62%).
• Positive X-ray results showed significant correlations with post-tussive emesis and purulent nasal discharge.
• Sinus X-ray abnormalities were strongly associated with most clinical findings, excluding wheezing.

Conclusions:

• Sinus abnormalities detected via X-ray are present in 65% of children with chronic cough.
• The Water's view sinus X-ray serves as a valuable initial screening tool for clinicians managing pediatric chronic cough.
• Specific physical signs and symptoms, when occurring together, correlate well with abnormal sinus X-ray findings.