Keywords: acute sinusitis, rhinorrhea, paranasal sinus x-rayfilm, sinus radiograph

Abstract: Introduction: Acute sinusitis (AS) is an inflammation of the paranasal caviry mucosa until four weeks. The physical examination usually presents purulent drainage in the region of the middle meatus (MM), which is a pathognomonic data. The radiographic abnormalities that may be observed at the paranasal sinus x-ray film (PNS xR) are: mucosal thickening, fluid level Or complete sinus opacification. Purpose: This study compares positive PNS xR with clinical findings and defines the indication to make a radiograph examination in urgency service. Material and Methods: One hundred patients with symptoms of sinusitis were examined prospectively: 56,6% of the patients with drainage in the MM, showed positive signs at the PNS xR; on the other hand, 40,5% of the cases with AS signs at the x-ray film, was with purulent secretion in the MM. Conclusion: This purulent fluid observed at the nasal fossa examination doesn't mean that a positive paranasal sinus radiograph will be find. The presence of purulent drainage in the MM has low sensivity and high specificity. Symptoms like headache/facial pain, purulent rhinorrhea and nasal obstruction are very suggestive of AS, in despite of physical examination or sinus radiograph. The PNS xR showed high level of false-negative. This radiographic examination is helpful if it is analysed in association with the symptoms and signs found in each patient. However, if it is analysed alone, it doesn't show significant value. It's necessary clinical criterion for determine its utility.