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Comparison of sinus x-rays with computed tomography scans in acute sinusitis
T F Burke1, A T Guertler, J H Timmons
1Department of Emergency Medicine, Madigan Army Medical Center, Ft. Lewis, WA 98431, USA.
Summary
Sinus X-rays show low sensitivity for diagnosing acute sinusitis compared to CT scans. Plain sinus films may not be reliable for clinical decisions, suggesting CT scans for diagnostic certainty.
Area of Science:
- Radiology
- Emergency Medicine
- Otolaryngology
Background:
- Acute sinusitis is a common condition diagnosed clinically.
- Imaging studies are sometimes used to confirm diagnosis or rule out complications.
Purpose of the Study:
- To evaluate the diagnostic accuracy of plain sinus X-rays compared to computed tomography (CT) scans for acute sinusitis.
Main Methods:
- 30 emergency department patients with clinical acute sinusitis underwent X-rays and CT scans within 72 hours.
- Radiologic criteria included mucoperiosteal thickening, air/fluid levels, or opacification.
- Readings were performed in a blinded fashion by radiologists and emergency medicine physicians.
Main Results:
- CT scans confirmed sinusitis in 21 of 29 patients.
- X-ray sensitivity ranged from 48% to 67%, with specificity from 75% to 100%.
- Maxillary sinus sensitivity was 70% and specificity 96-100% on X-ray.
Conclusions:
- Plain sinus X-rays demonstrate lower sensitivity than CT scans for acute sinusitis.
- X-ray findings may not be sufficiently reliable for clinical decision-making.
- CT scans are recommended for definitive diagnosis when certainty is required.
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