Sinusitis vs Rhinitis: A Differential Diagnosis

Doctor in the House

Know Dr. Gregory House? Yup, he’s that limping, grouchy, brilliant doctor in the series House, M.D. who works with his team on differential diagnosis. Be it in real or reel life, making a differential diagnosis is very important because unfortunately, symptoms are hardly ever exclusive to a particular disease. Example, the manifestation of a headache can mean a patient has anything from a simple all-you-need-is-to-rest stress headache, to a very life-threatening I’m-so-sorry-you’ve-only-got-some-months-to-live brain tumor. To give the proper medical management, it is necessary to establish the most likely diagnosis by considering the whole clinical picture and minding other symptoms that the patient may also present with.

Fortunately, not every case of differential diagnosis means reconciling mind-boggling medical contradictions. For instance, everyone practically experiences nasal congestion. And usually, there are only two conditions that can present with this manifestation - rhinitis (inflammation of the nasal passages, usually due to a nasal allergy) and sinusitis (inflammation and usually, infection of the sinus/es). So if you wake up with a stuffy nose and you’re wondering whether you’ve got just the nose thing or you’ve got even your sinuses affected, here is something that could help you.

What Anatomy Tells You

The nasal passages and sinus cavities have a relationship because of their proximity and involvement in respiratory function. In fact, the sinuses’ openings (ostia) open into the nasal cavities to allow drainage of sinus mucus. Since the nasal cavities are more exposed to external environment, they are more prone to allergens and irritants that could cause an inflammatory reaction. And when the condition remains unchecked for quite awhile, it may cause the inflammation and infection of the more distantly located sinuses. Thus, this tells you that while rhinitis may occur on its own; it is quite unlikely to have sinusitis without rhinitis.

Spot the Difference

Both rhinitis and sinusitis can make you feel congested because both cause production of copious mucus. Both conditions may also necessitate you to blow your nose. However, while rhinitis often presents with clear, almost watery nasal secretion; sinusitis causes thick, yellow to green nasal secretion. Moreover, when the sinus openings to the nose are blocked, the secretions in the sinuses may attempt to drain through the throat instead. This is why post-nasal drips, throat clearing and cough are more likely to happen in sinusitis.

Sneezing and itching are often seen in cases of nasal allergy. They are the body’s way of attempting to get rid of allergens and other foreign matter from the nasal cavities. On the other hand, headaches and facial pain are more characteristic of sinusitis. The pain results from the pent-up pressure from the obstructed sinuses.  

Hitting Two Birds with One Stone

The course of treatment for nasal problems like nasal allergy, and sinus infections, isn’t entirely the same. That is why differentiating them was necessary in the first place. However, because some of the processes involved occur in both, there are some medications and treatment approaches that can work for both of them. Sinus Dynamics, a leading pharmaceutical company, specializes in compounding or customizing nasal allergy and sinusitis prescription medications in forms suitable for medicated irrigation and nebulization. Aside from compounding medications, they also develop and manufacture top-of-the-line nebulizers and irrigators.