Symptoms: 2 or more of nasal congestion/obstruction, discolored nasal discharge, or cough
ARS is clinical diagnosis, which does not require imaging or endoscopy to make initial diagnosis
Image to assess for complications, surgical planning, or unclear clinical diagnosis (uncommon)
Classified into VRS vs. ABRS based on clinical presentation
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Martins M et al: Management of post-septal complications of acute rhinosinusitis in children: a 14-year experience in a tertiary hospital. Int J Pediatr Otorhinolaryngol. 151:110925, 2021
Velasquez N et al: Clinical and radiologic characterization of frontal sinusitis in the pediatric population. Ann Otol Rhinol Laryngol. 130(8):923-8, 2021
Blanco CH et al: Management of complicated pediatric rhinosinusitis in the COVID-19 era. Am J Otolaryngol. 41(6):102746, 2020
DeBoer DL et al: Acute sinusitis. StatPearls Publishing, 2020
Frerichs N et al: Rhinosinusitis and the role of imaging. Cleve Clin J Med. 87(8):485-92, 2020
Harreld JH et al: The use of imaging to identify immunocompromised children requiring biopsy for invasive fungal rhinosinusitis. Pediatr Blood Cancer. 67(11):e28676, 2020
Orlandi RR et al: International Consensus Statement on rhinology and allergy: rhinosinusitis. Int Forum Allergy Rhinol. 11(3):213-739, 2020
Orman G et al: Imaging of paranasal sinus infections in children: a review. J Neuroimaging. 30(5):572-86, 2020
Expert Panel on Neurologic Imaging et al: ACR Appropriateness Criteria® sinonasal disease. J Am Coll Radiol. 14(11S):S550-9, 2017
Bergmark RW et al: Socioeconomic determinants of overnight and weekend emergency department use for acute rhinosinusitis. Laryngoscope. 125(11):2441-6, 2015
Costa ML et al: Medical therapy vs surgery for recurrent acute rhinosinusitis. Int Forum Allergy Rhinol. 5(8):667-73, 2015
Dankbaar JW et al: Imaging findings of the orbital and intracranial complications of acute bacterial rhinosinusitis. Insights Imaging. 6(5):509-18, 2015
El-Hennawi DM et al: Comparative study of the efficacy of topical steroid and antibiotic combination therapy versus oral antibiotic alone when treating acute rhinosinusitis. J Laryngol Otol. 129(5):462-7, 2015
Joshi VM et al: Imaging in sinonasal inflammatory disease. Neuroimaging Clin N Am. 25(4):549-68, 2015
Khalid AN et al: Association of vitamin D status and acute rhinosinusitis: results from the United States National Health and Nutrition Examination Survey 2001-2006. Medicine (Baltimore). 94(40):e1447, 2015
King D et al: Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev. 4:CD006821, 2015
Lee JH et al: Underestimation of rhinogenic causes in patients presenting to the emergency department with acute headache. Acta Neurol Taiwan. 24(2):37-42, 2015
Rosenfeld RM et al: Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 152(2 Suppl):S1-S39, 2015
Esposito S et al: Diagnosis of acute rhinosinusitis. Pediatr Allergy Immunol. 23 Suppl 22:17-9, 2012
Bayonne E et al: Intracranial complications of rhinosinusitis. A review, typical imaging data and algorithm of management. Rhinology. 47(1):59-65, 2009
Madani G et al: Sinonasal inflammatory disease. Semin Ultrasound CT MR. 30(1):17-24, 2009
Saarakkala S et al: Comprehensive optimization process of paranasal sinus radiography. Acta Radiol. 2009 Apr;50(3):327-33. Erratum in: Acta Radiol. 50(5):575, 2009
Pearlman AN et al: Review of current guidelines related to the diagnosis and treatment of rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 16(3):226-30, 2008
Rosenfeld RM et al: Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg. 137(3 Suppl):S1-31, 2007
Triulzi F et al: Imaging techniques in the diagnosis and management of rhinosinusitis in children. Pediatr Allergy Immunol. 18 Suppl 18:46-9, 2007
Le Annie V et al: Making the call: the diagnosis of acute community-acquired bacterial sinusitis. Am J Rhinol. 20(6):658-61, 2006
Mafee MF et al: Imaging of rhinosinusitis and its complications: plain film, CT, and MRI. Clin Rev Allergy Immunol. 30(3):165-86, 2006
Anand VK: Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 193:3-5, 2004
Vázquez E et al: Complicated acute pediatric bacterial sinusitis: Imaging updated approach. Curr Probl Diagn Radiol. 33(3):127-45, 2004
Zinreich SJ: Imaging for staging of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 193:19-23, 2004
Aalokken TM et al: Conventional sinus radiography compared with CT in the diagnosis of acute sinusitis. Dentomaxillofac Radiol. 32(1):60-2, 2003
Reider JM et al: Do imaging studies aid diagnosis of acute sinusitis? J Fam Pract. 52(7):565-7; discussion 567, 2003
Kenny TJ et al: Prospective analysis of sinus symptoms and correlation with paranasal computed tomography scan. Otolaryngol Head Neck Surg. 125(1):40-3, 2001
Varonen H et al: Comparison of ultrasound, radiography, and clinical examination in the diagnosis of acute maxillary sinusitis: a systematic review. J Clin Epidemiol. 53(9):940-8, 2000
Larson TL: Sinonasal inflammatory disease: pathophysiology, imaging, and surgery. Semin Ultrasound CT MR. 20(6):379-90, 1999
Symptoms: 2 or more of nasal congestion/obstruction, discolored nasal discharge, or cough
ARS is clinical diagnosis, which does not require imaging or endoscopy to make initial diagnosis
Image to assess for complications, surgical planning, or unclear clinical diagnosis (uncommon)
Classified into VRS vs. ABRS based on clinical presentation
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Martins M et al: Management of post-septal complications of acute rhinosinusitis in children: a 14-year experience in a tertiary hospital. Int J Pediatr Otorhinolaryngol. 151:110925, 2021
Velasquez N et al: Clinical and radiologic characterization of frontal sinusitis in the pediatric population. Ann Otol Rhinol Laryngol. 130(8):923-8, 2021
Blanco CH et al: Management of complicated pediatric rhinosinusitis in the COVID-19 era. Am J Otolaryngol. 41(6):102746, 2020
DeBoer DL et al: Acute sinusitis. StatPearls Publishing, 2020
Frerichs N et al: Rhinosinusitis and the role of imaging. Cleve Clin J Med. 87(8):485-92, 2020
Harreld JH et al: The use of imaging to identify immunocompromised children requiring biopsy for invasive fungal rhinosinusitis. Pediatr Blood Cancer. 67(11):e28676, 2020
Orlandi RR et al: International Consensus Statement on rhinology and allergy: rhinosinusitis. Int Forum Allergy Rhinol. 11(3):213-739, 2020
Orman G et al: Imaging of paranasal sinus infections in children: a review. J Neuroimaging. 30(5):572-86, 2020
Expert Panel on Neurologic Imaging et al: ACR Appropriateness Criteria® sinonasal disease. J Am Coll Radiol. 14(11S):S550-9, 2017
Bergmark RW et al: Socioeconomic determinants of overnight and weekend emergency department use for acute rhinosinusitis. Laryngoscope. 125(11):2441-6, 2015
Costa ML et al: Medical therapy vs surgery for recurrent acute rhinosinusitis. Int Forum Allergy Rhinol. 5(8):667-73, 2015
Dankbaar JW et al: Imaging findings of the orbital and intracranial complications of acute bacterial rhinosinusitis. Insights Imaging. 6(5):509-18, 2015
El-Hennawi DM et al: Comparative study of the efficacy of topical steroid and antibiotic combination therapy versus oral antibiotic alone when treating acute rhinosinusitis. J Laryngol Otol. 129(5):462-7, 2015
Joshi VM et al: Imaging in sinonasal inflammatory disease. Neuroimaging Clin N Am. 25(4):549-68, 2015
Khalid AN et al: Association of vitamin D status and acute rhinosinusitis: results from the United States National Health and Nutrition Examination Survey 2001-2006. Medicine (Baltimore). 94(40):e1447, 2015
King D et al: Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev. 4:CD006821, 2015
Lee JH et al: Underestimation of rhinogenic causes in patients presenting to the emergency department with acute headache. Acta Neurol Taiwan. 24(2):37-42, 2015
Rosenfeld RM et al: Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 152(2 Suppl):S1-S39, 2015
Esposito S et al: Diagnosis of acute rhinosinusitis. Pediatr Allergy Immunol. 23 Suppl 22:17-9, 2012
Bayonne E et al: Intracranial complications of rhinosinusitis. A review, typical imaging data and algorithm of management. Rhinology. 47(1):59-65, 2009
Madani G et al: Sinonasal inflammatory disease. Semin Ultrasound CT MR. 30(1):17-24, 2009
Saarakkala S et al: Comprehensive optimization process of paranasal sinus radiography. Acta Radiol. 2009 Apr;50(3):327-33. Erratum in: Acta Radiol. 50(5):575, 2009
Pearlman AN et al: Review of current guidelines related to the diagnosis and treatment of rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 16(3):226-30, 2008
Rosenfeld RM et al: Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg. 137(3 Suppl):S1-31, 2007
Triulzi F et al: Imaging techniques in the diagnosis and management of rhinosinusitis in children. Pediatr Allergy Immunol. 18 Suppl 18:46-9, 2007
Le Annie V et al: Making the call: the diagnosis of acute community-acquired bacterial sinusitis. Am J Rhinol. 20(6):658-61, 2006
Mafee MF et al: Imaging of rhinosinusitis and its complications: plain film, CT, and MRI. Clin Rev Allergy Immunol. 30(3):165-86, 2006
Anand VK: Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 193:3-5, 2004
Vázquez E et al: Complicated acute pediatric bacterial sinusitis: Imaging updated approach. Curr Probl Diagn Radiol. 33(3):127-45, 2004
Zinreich SJ: Imaging for staging of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 193:19-23, 2004
Aalokken TM et al: Conventional sinus radiography compared with CT in the diagnosis of acute sinusitis. Dentomaxillofac Radiol. 32(1):60-2, 2003
Reider JM et al: Do imaging studies aid diagnosis of acute sinusitis? J Fam Pract. 52(7):565-7; discussion 567, 2003
Kenny TJ et al: Prospective analysis of sinus symptoms and correlation with paranasal computed tomography scan. Otolaryngol Head Neck Surg. 125(1):40-3, 2001
Varonen H et al: Comparison of ultrasound, radiography, and clinical examination in the diagnosis of acute maxillary sinusitis: a systematic review. J Clin Epidemiol. 53(9):940-8, 2000
Larson TL: Sinonasal inflammatory disease: pathophysiology, imaging, and surgery. Semin Ultrasound CT MR. 20(6):379-90, 1999
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