Difficulties in diagnosing acute sinusitis in a Dutch group practice: Relative value of history, radiography and ultrasound

Objectives: To determine the degree of agreement between (1) history, ultrasound and radiographic examinations, and (2) between two ultrasound and two radiographie examinations in the diagnosis of acute sinusitis in a local situation.Methods: This cross-sectional pilot study was undertaken among patients on the list of a Dutch group practice (six GPs), in cooperation with the ENT and radiography departments of a local hospital. Included were patients aged 15 to 65 years with one or more of the following symptoms: purulent nasal discharge; pain in the sinuses on bending forward; predominantly unilateral maxillary pain and pain in teeth or on mastication; the above symtoms after a common cold or influenza. The main outcome measure was agreement, calculated by Kappa statistics, between the results of diagnosing acute sinusitis from the history, following the guidelines of the Dutch College of General Practitioners (DCGP), and by ultrasound and radiography.Results: Of 60 evaluated patients, acute sinusitis wa...