Master Rhinosinusitis Assessment with Picmonic for Physician Assistant

Rhinosinusitis is caused by an obstruction of the sinuses, typically maxillary sinuses, preventing fluid from entering the nasal cavity. This increases pressure in the sinuses which leads to inflammation and facial pain. It's commonly acute and may be preceded by a viral URI. Common pathogens include S pneumoniae, H influenzae, or M catarrhalis.

Patients may have purulent nasal drainage, nasal congestion, nares may be red and swollen due to irritation, and/or patient may have postnasal drip.

Patients may express dull pain or congestion on specific areas of the face corresponding to the infected sinus (frontal, maxillary, ethmoid, or sphenoid).

Pain or tenderness may be reported over the lower forehead, if the frontal sinus is obstructed.

Pain or tenderness may be felt over the cheeks or referred to the teeth if the maxillary sinuses are obstructed.

Patients may report pain over the bridge of their nose, if the ethmoid sinus is obstructed.

Patients may feel pain or tenderness behind their eyes if the sphenoid sinuses are obstructed.

Patients may or may not have a severe fever depending on preceding conditions leading to rhinosinusitis. Worsening symptoms including a new fever, headache, or nasal drainage may mean that rhinosinusitis is following an URI.

Patients may report symptoms for 10 days or more.