Diagnosing sinusitis by X-ray: is a single Waters view adequate?
OBJECTIVE
To determine whether a single Waters view (occipito-mental) radiograph could be substituted for a four-view sinus series to diagnose sinusitis, and to determine the inter- and intraobserver variabilities for sinus radiography.


METHODS
Radiographs were interpreted by radiologists blinded to the clinical history, and results were recorded on a standardized form.


METHODS
Veterans Affairs Medical Center.


METHODS
Staff attending radiologists, an attending radiologist with special training in skull radiology, and a senior radiology resident.


RESULTS
The agreement between the Waters view and the four-view sinus series was moderate to substantial (simple agreement = 75-84%, kappa = 0.5-0.68). However, agreement varied by sinus and, after correction for chance agreement, was substantial only for the maxillary sinuses (kappa = 0.72-0.87). Intraobserver agreement (kappa = 0.72-0.84) was superior to interobserver agreement (kappa = 0.49-0.59) for the four-view sinus series.


CONCLUSIONS
Substituting a single Waters view for a four-view sinus series may be an acceptable strategy for diagnosing maxillary sinusitis.
Williams
J W
JW
Center for Health Services Research in Primary Care, Durham VAMC, North Carolina.
Roberts
L
L
Distell
B
B
Simel
D L
DL
D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011859:Radiography / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D012852:Sinusitis / Q000000981:diagnostic imaging*