To the Editor.—
In 1980 we reported the cost-effectiveness of routine laboratory tests in the examination of patients with chronic urticaria.1 We concluded that, with the possible exception of sinus roentgenograms, the laboratory studies evaluated were not likely to be helpful in determining a cause or managing chronic urticaria unless there were suggestive findings in the history and physical examination. Sinus roentgenograms were considered a possible exception because results of 11 of 64 studies were abnormal, the presence of sinus disease was not suspected before the examinations were performed, and it seemed that the urticaria subsided with clearing of the sinusitis. For these reasons we suggested that, until further studies had been performed, sinus roentgenograms should be considered in all patients with chronic urticaria, especially in those cases of recent onset.Subsequently we have attempted to assess the value of routine sinus roentgenograms in patients with chronic urticaria. Our
Nelson HS. Routine Sinus Roentgenograms and Chronic Urticaria. JAMA. 1984;251(13):1680–1681. doi:10.1001/jama.1984.03340370020010
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