In a 26-year-old with sinus symptoms, which diagnostic study is the gold standard for sinus imaging?

• A. Transillumination of sinuses.
• B. Routine sinus films.
• C. CT scan of sinuses.
• D. Nasal culture.

Answer: (C)

CT scan of the sinuses provides the most accurate and comprehensive view of sinus disease. It offers detailed cross-sectional images of all paranasal sinuses, showing mucosal thickening, air-fluid levels, and obstruction of the ostiomeatal complex, as well as any complications or anatomical variations. This level of detail makes it the best imaging choice when imaging is indicated for sinus symptoms, and it also aids in surgical planning if needed. Other options don’t fit as well: transillumination is unreliable and operator-dependent, routine sinus films miss many cases due to overlapping structures, and a nasal culture doesn’t image the sinuses or show the extent of disease. In suspected sinusitis, imaging isn’t always required, but when it is, CT is the preferred modality.