Contribution of chest and paranasal sinus radiographs to the management of acute asthma.

In order to evaluate the clinical utility of chest and paranasal sinus radiographs on admission in cases of acute asthma, the radiographs of adult patients admitted to our hospital for acute asthma over a period of 1 year were studied. The findings were specified afterwards by a senior diagnostic radiologist and their impact on the management of asthma was evaluated by reviewing the medical records of the patients retrospectively. Abnormalities were detected in 50% of the chest radiographs (55 of 110) and these resulted in management changes in 5% of cases (6 of 100). Abnormalities in any paranasal sinuses were detected in 85% of the sinus radiographs (93 of 100), and maxillary sinus abnormalities in 63% (70 of 100). 29% of the sinus abnormalities (32 of 110) resulted in an immediate alteration in treatment. Hence abnormalities were more common in the paranasal sinus radiographs than in the chest radiographs (p < 0.001), and the impact of the sinus radiographs on the treatment of asthma was also greater (p < 0.001). We recommend that while obtaining a chest radiograph routinely may be advisable in severe cases of acute asthma, at least when the patient is admitted to hospital, serious thought should be given to routinely obtaining a sinus radiograph in these cases as well.