What is the proper way to tell if someone has a sinus infection? Is it possible to know one way or the other just by looking in the nose for visible redness or inflammation?

L.M.

Here's the quick answer to your question: NO.

Now for the details. Sinus problems are sometimes very obvious. If you have foul-tasting, yellow or green mucus draining down your throat, pain in the forehead or cheek bones and puffiness around your eyes, then I don't even need to examine your nose to make a diagnosis of sinusitis. This dramatic picture usually occurs in acute sinusitis (sinus infection of recent onset).

On the other hand, longstanding, smoldering sinus problems (chronic sinusitis) can be very difficult to detect. There may be just a bit of nasal congestion, some occasional post-nasal drainage or perhaps just a suspicious headache. Even a thorough nasal examination with a fiber-optic telescope called an endoscope may fail to reveal any evidence of sinus disease.

In such tough cases, a CT or CAT scan of the sinuses is essential. A CT scan is a sophisticated X-ray that lets your doctor examine the anatomy of your sinuses in great deal. CT scans will often detect problems that are undetectable on even a very thorough nasal exam. Thus, if you are having troublesome symptoms that may be of sinus origin, an endoscopic examination of your nasal cavity and a CT of your sinuses would be an important part of your work-up.