Sinusitis: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
===History and physical examination=== | ===History and physical examination=== | ||
A [[systematic review]] by the [http://www.sgim.org/clinexam-rce.cfm Rational Clinical Examination] | A [[systematic review]] by the [http://www.sgim.org/clinexam-rce.cfm Rational Clinical Examination] concluded "maxillary toothache, poor response to nasal decongestants, abnormal transillumination, and colored nasal discharge by history or examination are the most useful clinical findings in primary care populations."<ref name="pmid8355389">{{cite journal |author=Williams JW, Simel DL |title=Does this patient have sinusitis? Diagnosing acute sinusitis by history and physical examination |journal=JAMA |volume=270 |issue=10 |pages=1242–6 |year=1993 |pmid=8355389 |doi=}} [http://gateway.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=8355389.ui OVID]</ref> More recently reported is that a "red streak in the lateral recess of the oropharynx predicts acutesinusitis." ([http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1831603&rendertype=figure&id=fig01 picture])<ref name="pmid16918746">{{cite journal |author=Thomas C, Aizin V |title=Brief report: a red streak in the lateral recess of the oropharynx predicts acute sinusitis |journal=J Gen Intern Med |volume=21 |issue=9 |pages=986–8 |year=2006 |pmid=16918746 |doi=10.1111/j.1525-1497.2006.00498.x}}</ref> | ||
===CT Scan=== | ===CT Scan=== | ||
Revision as of 00:39, 5 December 2007
Sinusitis is defined as "an inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism."[1]
Etiology/causes
Microbiology
Diagnosis
History and physical examination
A systematic review by the Rational Clinical Examination concluded "maxillary toothache, poor response to nasal decongestants, abnormal transillumination, and colored nasal discharge by history or examination are the most useful clinical findings in primary care populations."[2] More recently reported is that a "red streak in the lateral recess of the oropharynx predicts acutesinusitis." (picture)[3]
CT Scan
Interpreting abnormal CT scan results is difficult because most patients with a common cold will have abnormalities of the maxillary sinuses.[4]
Treatment
Topical antibiotics do not seem to help.[5]
Topical corticosteroids do not seem to help.[5]
References
- ↑ National Library of Medicine. Sinusitis. Retrieved on 2007-12-04.
- ↑ Williams JW, Simel DL (1993). "Does this patient have sinusitis? Diagnosing acute sinusitis by history and physical examination". JAMA 270 (10): 1242–6. PMID 8355389. [e] OVID
- ↑ Thomas C, Aizin V (2006). "Brief report: a red streak in the lateral recess of the oropharynx predicts acute sinusitis". J Gen Intern Med 21 (9): 986–8. DOI:10.1111/j.1525-1497.2006.00498.x. PMID 16918746. Research Blogging.
- ↑ Gwaltney JM, Phillips CD, Miller RD, Riker DK (1994). "Computed tomographic study of the common cold". N. Engl. J. Med. 330 (1): 25–30. PMID 8259141. [e]
- ↑ 5.0 5.1 Ian G. Williamson et al., “Antibiotics and Topical Nasal Steroid for Treatment of Acute Maxillary Sinusitis: A Randomized Controlled Trial,” JAMA 298, no. 21 (December 5, 2007), http://jama.ama-assn.org/cgi/content/abstract/298/21/2487 (accessed December 5, 2007).