A tender sinus does not always mean rhinosinusitis.
BACKGROUND
Sinus tenderness has not been quantitatively assessed.


OBJECTIVE
We sought to compare sinus and systemic tenderness in rhinosinusitis, allergic rhinitis, and chronic fatigue syndrome (CFS), and healthy (non-CFS) groups.


METHODS
Cutaneous pressures (kg/cm(2)) causing pain at 5 sinus and 18 systemic sites were measured in acute and chronic rhinosinusitis, active allergic rhinitis, healthy non-CFS/no rhinosinusitis, and CFS subjects.


RESULTS
Sinus thresholds differed significantly (P </= 10(-11), ANOVA) between non-CFS/no rhinosinusitis (1.59 +/- 0.14 kg/cm(2), mean +/- 95% CI, n = 117), allergic rhinitis (1.19 +/- 0.31, n = 30), exacerbations of chronic rhinosinusitis (1.25 +/- 0.26, n = 25), non-CFS/chronic rhinosinusitis (1.23 +/- 0.27, n = 23), acute rhinosinusitis (1.10 +/- 0.20, n = 22), CFS/no rhinosinusitis (0.98 +/- 0.15, n = 70), and CFS/chronic rhinosinusitis (0.78 +/- 0.12, n = 56). Systemic pressure thresholds were lower for CFS (1.46 +/- 0.15) than for non-CFS (2.67 +/- 0.22, P </= 10(-11)).


CONCLUSIONS
The lower sinus thresholds of rhinosinusitis groups validated the sign of sinus tenderness. Sinus and systemic thresholds were both 44% lower in CFS than in non-CFS subjects, suggesting that systemic hyperalgesia contributed to CFS sinus tenderness and "rhinosinusitis" complaints.
Naranch
K
K
Chronic Pain and Fatigue Research Center, Division of Rheumatology, Immunology and Allergy, Georgetown University, Washington, DC 20007-2097, USA.
Park
Y-J
YJ
Repka-Ramirez
M S
MS
Velarde
A
A
Clauw
D
D
Baraniuk
J N
JN
D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D003937:Diagnosis, Differential; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D017288:Pain Threshold; D010256:Paranasal Sinuses / Q000503:physiopathology*; D011312:Pressure / Q000009:adverse effects*; D012220:Rhinitis / Q000175:diagnosis* / Q000503:physiopathology*; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000503:physiopathology*; D012852:Sinusitis / Q000175:diagnosis* / Q000503:physiopathology*; D014110:Touch / Q000502:physiology*