title: ACR appropriateness criteria sinonasal disease.
abstract: Sinonasal imaging is performed in 2 major clinical scenarios: inflammatory rhinosinusitis or suspected mass lesion. Rhinosinusitis affects more than 16% of the US population annually. It poses an immense economic burden, accounting for more than 26 million outpatient visits annually and costing more than $4.3 billion annually in direct medical expenses. Most cases of uncomplicated acute and subacute rhinosinusitis are diagnosed clinically and should not require any imaging procedure. CT of the sinuses without contrast is the imaging method of choice in patients with recurrent acute sinusitis or chronic sinusitis. Sinusitis cannot be diagnosed on the basis of imaging findings alone. CT scan findings should be interpreted in conjunction with clinical and endoscopic findings. MRI is currently used for evaluation of sinus disease as a complementary study in cases of aggressive sinus infection with ocular/intracranial complications, potential invasive fungal sinusitis in immunocompromised patients or in the evaluation of a sinonasal mass. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors: University of Cincinnati, Cincinnati, OH, USA. beccacornel@aol.com
authors: Rebecca S
authors: RS
authors: Cornelius
authors: Jamie
authors: J
authors: Martin
authors: Franz J
authors: FJ
authors: Wippold
authors: Ashley H
authors: AH
authors: Aiken
authors: Edgardo J
authors: EJ
authors: Angtuaco
authors: Kevin L
authors: KL
authors: Berger
authors: Douglas C
authors: DC
authors: Brown
authors: Patricia C
authors: PC
authors: Davis
authors: Charles T
authors: CT
authors: McConnell
authors: Laszlo L
authors: LL
authors: Mechtler
authors: Brian
authors: B
authors: Nussenbaum
authors: Christopher J
authors: CJ
authors: Roth
authors: David J
authors: DJ
authors: Seidenwurm
mesh_terms: D003952:Diagnostic Imaging / Q000592:standards*; D006801:Humans; D011835:Radiation Protection / Q000592:standards*; D011871:Radiology / Q000592:standards*; D012220:Rhinitis / Q000175:diagnosis*; D012852:Sinusitis / Q000175:diagnosis*; D014481:United States