title: Diagnostic accuracy of acute maxillary sinusitis in adults in primary care.
abstract: OBJECTIVE
  To evaluate the diagnostic value of symptoms and signs used in diagnosing acute community-acquired maxillary sinusitis (ACAMS), and to find useful clinical predictors for diagnosing it in adults in primary care.
  
  
  METHODS
  Prospective study in the study group and retrospective study in the reference group.
  
  
  METHODS
  One primary care centre in the study group and another in the reference group.
  
  
  METHODS
  50 adults with prolonged upper respiratory tract infection > or = 7 days) or self-suspected maxillary sinusitis. As a reference group, an analysis of records and diagnoses made by GP of 45 adult patients with the same inclusion criteria from another primary care clinic.
  
  
  METHODS
  The signs and symptoms associated with the diagnosis of ACAMS by GP and otorhinolaryngologist. The value of CRP, ultrasound and peak nasal expiratory flow in the diagnosis.
  
  
  RESULTS
  Neither ultrasound nor any of the clinical signs increased the accuracy of diagnosis. Peak nasal expiratory flow below the normal range was associated with the diagnosis of ACAMS (p = 0.03). The presence of an otorhinolaryngologist had an influence on GP practice when compared with the reference group.
  
  
  CONCLUSIONS
  The diagnosis of ACAMS is difficult with the available clinical methods. Peak nasal expiratory flow needs further study. New diagnostic means are needed.
authors.affiliation: Department of Otorhinolaryngology, University Central Hospital, Helsinki, Finland. ekv_blomgren@hotmail.com
authors.forename: Karin
authors.initials: K
authors.lastname: Blomgren
authors.forename: Maija
authors.initials: M
authors.lastname: Hytönen
authors.forename: Jukka
authors.initials: J
authors.lastname: Pellinen
authors.forename: Markus
authors.initials: M
authors.lastname: Relander
authors.forename: Anne
authors.initials: A
authors.lastname: Pitkäranta
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D017714:Community-Acquired Infections / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003939:Diagnostic Techniques, Otological / Q000592:standards*; D005194:Family Practice / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008875:Middle Aged; D010036:Otolaryngology / Q000379:methods* / Q000592:standards; D010366:Peak Expiratory Flow Rate; D010474:Percussion / Q000592:standards; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D002097:C-Reactive Protein