Emerging techniques in the diagnosis of sinusitis.

In recent years, the high prevalence of chronic sinusitis has been noted in isolation and in association with bronchial asthma, aspirin sensitivity, and perennial rhinitis. Many sinus-associated symptoms arise from nasal rather than sinus pathology; thus, it is important to detect the presence, extent, and nature of any disease within the sinus cavities. Conventional plain radiographs have limited sensitivity and have been supplanted by more widespread use of computerized tomography. The role of other modalities such as ultrasound and magnetic resonance imaging has not yet been completely determined. Other tests such as cytology and endoscopy can detect the presence of infection without the need for invasive antral puncture. Practitioners should consider the impact of a negative imaging test on their therapeutic plan and order tests on that basis.