Choosing Wisely:

Don’t routinely obtain radiographic imaging for patients who meet diagnostic criteria for uncomplicated acute rhinosinusitis.

Rationale and Comments: Imaging of the paranasal sinuses, including plain film radiography, CT, and MRI, is unnecessary in patients who meet the clinical diagnostic criteria for uncomplicated acute rhinosinusitis. Acute rhino-sinusitis is defined as up to four weeks of purulent nasal drainage (anterior, posterior, or both) accompanied by nasal obstruction, facial pain-pressure-fullness, or both. Imaging is costly and may expose patients to radiation. Imaging may be appropriate in patients with a complication of acute rhinosinusitis, patients with comorbidities that predispose them to complications, and patients in whom an alternative diagnosis is suspected.
Sponsoring Organizations:
  • American Academy of Otolaryngology–Head and Neck Surgery Foundation
  • Sources:
  • American Academy of Otolaryngology–Head and Neck Surgery Foundation practice guidelines
  • Disciplines:
  • Otolaryngologic
  • Infectious disease
  • References: • Rosenfeld RM, et al. Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg. 2007;137(3 suppl):S1-31.

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