X-ray PNS (Paranasal Sinuses) — PA (Caldwell-like) View

Image Type & Orientation

• Modality: Plain X-ray (radiograph), posteroanterior (PA) skull/PNS view
• "R" marker on the left side of the image = patient's right side
• The cervical spine is visible inferiorly (C1–C4 region)

Systematic Findings

Frontal Sinuses

• Both frontal sinuses are visible and appear reasonably aerated, though the image quality and angle make precise assessment difficult. No obvious complete opacification.

Ethmoid Sinuses

• The ethmoid air cells in the midline region appear partially hazed/opacified, suggesting possible mucosal thickening or inflammatory changes.

Maxillary Sinuses (Antra)

• Both maxillary sinuses are visible.
• There is haziness in the left maxillary sinus (right side of image, which is the patient's left) compared to the right — this may indicate mucosal thickening or fluid accumulation, consistent with sinusitis.
• The right maxillary sinus appears relatively more aerated.

Nasal Septum

• The nasal septum appears to show a mild deviation, though this requires clinical correlation.

Orbits

• Both orbital rims appear intact. No obvious bony disruption.

Calvarium / Skull Vault

• The outer and inner tables of the skull appear intact. No obvious lytic lesions or fracture lines are seen on this view.

Cervical Spine

• Visible upper cervical vertebrae (C1–C5 region) — alignment appears grossly intact on this view, but a dedicated cervical spine series would be needed for full assessment.

Impression

Clinical Correlation Points

• Sinus opacification/haziness on X-ray may represent: acute sinusitis, chronic sinusitis, mucosal polyps, retention cysts, or (rarely) tumors. (Cummings Otolaryngology, Paranasal Sinuses section)
• Plain X-ray PNS has limited sensitivity compared to CT scan. If clinical symptoms are significant, a CT PNS (non-contrast coronal cuts) is the gold standard for detailed sinus anatomy and disease extent.
• Clinical symptoms (nasal blockage, facial pain/pressure, purulent discharge, fever) should guide management.

Disclaimer: This is an AI-assisted image analysis for educational purposes only. Formal radiological interpretation must be performed by a qualified radiologist in the clinical context of the patient.