Diagnosis of maxillary sinusitis in Finnish primary care. Use of imaging techniques.
OBJECTIVE
To observe the effect of imaging techniques on the diagnostic pattern of sinusitis in primary care.


METHODS
A multicentre survey.


METHODS
14 health centres with varying facilities for clinical imaging.


METHODS
446 adult patients with a suspicion of acute maxillary sinusitis. Ultrasound or radiography facilities existed in 337 cases while 109 could only be judged clinically. MAIN outcome measures--The use of ultrasound, radiography, laboratory tests, irrigation and control visits. The final number of patients with sinusitis in different facility groups.


RESULTS
When available, ultrasound was used in 82-92% and radiography in 6-32% of cases. The ultrasound finding showed mucosal thickening or was difficult to interpret in every third case; one half of these were interpreted as sinusitis and the rest were considered healthy. In total, sinusitis was diagnosed in 84-88% when ultrasound or radiography only could be used, and in 77% when both techniques were available (p < 0.01). Simultaneously the general practitioners' confidence in the correctness of their diagnosis increased from 39% to 66%.


CONCLUSIONS
When possible, ultrasound is widely used in diagnosing sinusitis in Finnish primary care. The use of ultrasound slightly diminished the numbers of sinusitis diagnoses but the techniques of using and interpreting ultrasound findings need to be improved.
Mäkelä
M
M
National research and development centre for welfare and health, Helsinki, Finland.
Leinonen
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D011320:Primary Health Care; D011859:Radiography; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D014463:Ultrasonography
D000900:Anti-Bacterial Agents