Acute sinusitis in children: is the Water's view sufficient?

The purpose of this study was to examine the utility of the Water's view in the diagnosis of acute sinusitis in children. The records of all pediatric (less than 18 years old) patients who underwent sinus radiography for suspected acute sinusitis between February 1991 and November 1992 were reviewed. All radiographs were reviewed by an attending radiologist and the interpretation of the Water's (occipitomental) view alone was compared to that of a three-view (anterior/posterior, lateral, Water's) series. Fifty-two three-view sinus series were obtained on pediatric patients during the study period. Twenty-eight patients were diagnosed with acute sinusitis based on the three-view series. When compared to the three-view series, the single Water's view had a sensitivity of 89%, specificity of 83%, positive predictive value of 87%, and negative predictive value of 87%. The overall accuracy of the Water's view in diagnosing childhood acute sinusitis was 87%. The authors conclude that the Water's view is usually sufficient in the evaluation of suspected acute sinusitis in children.