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Lawrence J. Gordon, MD
New York Eye and Ear Infirmary New York, NY

JAMA. 1994;271(7):502.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The review and study by Williams and Simel¹ is an admirable attempt to answer the often-asked question, "Does this patient have sinusitis?" This is a problem that most primary care physicians should be prepared to deal with and treat appropriately. I have several concerns with the facts as stated in this article. The authors state that sinus aspiration and culture is the "gold standard"; however, this is not often used because of the difficulty in obtaining a specimen and the difficulty in culturing the anaerobic bacteria responsible for much of chronic sinusitis. They in turn refer to sinus roentgenograms as a readily obtained and pragmatic reference standard.

A four-view sinus series may be useful as an adjunct to the clinical examination in diagnosing acute sinusitis, especially acute frontal sinusitis. However, because of the often-reported discordance between plain films and sinus computed tomography (CT)^2-4 (the accepted . . . [Full Text PDF of this Article]

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