DIAGNOSIS OF MAXILLARY SINUSITIS IN FINNISH PRIMARY-CARE - USE OF IMAGING TECHNIQUES

Objective - To observe the effect of imaging techniques on the diagnos tic pattern of sinusitis in primary care. Design - A multicentre surve y. Setting - 14 health centres with varying facilities for clinical im aging. Subjects - 446 adult patients with a suspicion of acute maxilla ry sinusitis. Ultrasound or radiography facilities existed in 337 case s while 109 could only be judged clinically. Main outcome measures - T he use of ultrasound, radiography, laboratory tests, irrigation and co ntrol 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 m ucosal thickening or was difficult to interpret in every third case; o ne half of these were interpreted as sinusitis and the rest were consi dered healthy. In total, sinusitis was diagnosed in 84-88% when ultras ound or radiography only could be used, and in 77% when both technique s were available (p<0.01). Simultaneously the general practitioners' c onfidence in the correctness of their diagnosis increased from 39% to 66%.Conclusion - When possible, ultrasound is widely used in diagnosin g sinusitis in Finnish primary care. The use of ultrasound slightly di minished the numbers of sinusitis diagnoses but the techniques of usin g and interpreting ultrasound findings need to be improved.