Correlation of clinical sinusitis signs and symptoms to imaging findings in pediatric patients

The purpose of this study was to determine the correlation between signs and symptoms of upper respiratory tract disease and sinus images in a convenience sample of sixty pediatric patients scheduled for computed tomography or magnetic resonance imaging of the head for non-sinus diagnoses over a 2-year period. The study was carried out in a tertiary pediatric referral center. Each patient underwent rhinoscopy and otoscopy just prior to imaging, and each patient's parent was asked to fill out a questionnaire regarding recent symptoms of upper respiratory tract infection; a blinded comparison was then made between respiratory signs and symptoms and images of the paranasal sinuses. Forty-seven percent, of patients had abnormalities of their sinus images, and a significant ( P < 0.05) correlation was found between the presence or absence of respiratory signs and symptoms and the presence or absence of abnormalities of sinus images, especially in younger patients. In conclusion, a large percentage of pediatric patients undergoing imaging procedures of the head for non-sinus diagnoses have sinus image abnormalities. In the population studied, these imaging abnormalities appear to reflect ongoing or resolving upper respiratory tract viral or allergic inflammation.