In the literature considerable difference of opinion is expressed in regard to the importance of the accessory nasal sinuses as the primary or principal foci of infection in infectious arthritis. Snyder, Fineman, and Traeger,1 in a study of 386 routine unselected patients with chronic arthritis, found that 93 (practically 1 of every 4) had sinusitis, proved roentgenologically and clinically. The disease of the sinuses was most frequently asymptomatic, or "silent." Of these 93 patients, 51 received rhinologic treatments of either a conservative or a radical nature. The arthritis in these 51 patients, with few exceptions, improved greatly as a result of rhinologic treatment of the diseased sinuses. In 262 of the 386 patients (68 per cent) roentgenologic examination revealed slight, moderate or extreme changes suggestive or indicative of sinal disease. Of these 262 patients, 126 were subjected to rhinologic examination, and 93 were found to have clinical evidence of active
WILLIAMS HL, SLOCUMB CH. NASAL ACCESSORY SINUSES AS FOCI OF INFECTION IN ARTHRITIS. Arch Otolaryngol. 1939;29(5):829–834. doi:10.1001/archotol.1939.00650050891004
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