Ακτινογραφία για Ιγμορίτιδα;

[Argirios Argiriou]

Χρήσιμος διάλογος στις 10/04/2024 από Ιατρική ομάδα του facebook:

- Καλημερα!γραφετε η ακτινογραφια για ιγμοριτιδα;


- Δεν υπάρχει στην ηλεκτρονική συνταγογράφηση. Είμαι ακτινολόγος σε Κ.Υ.Οι γιατροί γράφουν κρανίου και σχόλιο
κόλπων προσώπου.

- ζητουσα κρανιου F κ στα σχολια ιγμορίων οπου φαινονται καλα οι κόλποι

[schumifer]

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Uptodate


DIAGNOSIS

Uncomplicated ABRS — The diagnosis of uncomplicated acute bacterial rhinosinusitis (ABRS) in children is usually made clinically. Imaging studies are not recommended for the diagnosis of uncomplicated ABRS [7].

We use both of the following criteria for diagnosis [6,7,26,33-35]:

●Symptoms and signs compatible with sinus inflammation (daytime cough, nasal symptoms, or both) (see 'Clinical features' above), and

●Clinical course suggestive of bacterial rather than viral infection, including (see 'Acute bacterial rhinosinusitis' above):

•Symptoms present without improvement for >10 and <30 days, or

•Severe symptoms (ill appearance, temperature ≥39°C (102.2°F), and purulent nasal discharge for ≥3 consecutive days), or

•Worsening symptoms (increase in respiratory symptoms, new onset of severe headache or fever, or recurrence of fever after initial improvement)

We have chosen these relatively strict criteria to limit the diagnosis to patients most likely to benefit from antimicrobial therapy [6]. These criteria agree with those of a multidisciplinary consensus panel and clinical guidelines developed by the American Academy of Pediatrics and the Infectious Diseases Society of America [6,7,34,35]. They are supported by a study in which 77 percent of sinus aspirate cultures in children with persistent or severe symptoms grew ≥104 colony forming units of pathogenic bacteria [26]. However, in approximately one-third of episodes of ABRS according to these criteria, sequential viral infections may be responsible for symptoms [13].






However, abnormal imaging studies cannot distinguish between bacterial, viral, or other causes of sinus inflammation [6,70]. Observational studies performed with radiographs, CT, and magnetic resonance imaging have demonstrated frequent abnormalities in the paranasal sinuses of children [67,71-73] and adults with uncomplicated viral upper respiratory infection [74].