II. Indication
- Acute Sinusitis Evaluation
III. Protocol: Williams and Berg Prediction Rules
- Criteria
- Maxillary Toothache
- Purulent nasal secretion
- History of colored Nasal Discharge
- Poor response to nasal Decongestants
- Abnormal Sinus Transillumination
- Modifiers
- Symptoms >7-10 days increases diagnostic efficacy
- Interpretation: Berg Prediction Rule
- Positive if 2 or more criteria positive
- Efficacy if symptoms present >7-10 days
- Berg (1988) Acta Otolaryngol 105:343-9 [PubMed]
- Interpretation: Williams Prediction Rule
- Positive if 4 or more criteria present
- Intermediate if 2 or 3 criteria present
- Study recommended sinus radiography
- Negative if <2 criteria present
- Williams (1992) Ann Intern Med 117:705-10 [PubMed]
IV. Task Force on Rhinosinusitis Prediction Rule
- Major Criteria
- Nasal obstruction or blockage
- Postnasal discharge or Rhinorrhea
- Hyposmia or Anosmia
- Major Criteria need accompanying other major criteria
- Facial pain, pressure, or fullness
- Fever (Acute Rhinosinusitis)
- Minor Criteria
- Interpretation: Positive for Acute Bacterial Sinusitis
- Two or more major criteria or
- One major criteria with two or more minor criteria or
- Nasal purulence seen on examination
- Reference