. Roentgen interpretation; a manual for students and practitioners . idered in making a is particularly true in the case of the frontals, where a degree ofdensity which is normal for one individual may be quite pathologicalin the case of another whose air space is larger and walls thinnerand whose sinuses should therefore appear darker. For the recog-nition of pathology, it is essential to compare the two sides and tohave a fairly definite mental picture of the appearance of the normalsinus. In the study of the frontals both anteroposterior and lateralviews must be combined. 88
. Roentgen interpretation; a manual for students and practitioners . idered in making a is particularly true in the case of the frontals, where a degree ofdensity which is normal for one individual may be quite pathologicalin the case of another whose air space is larger and walls thinnerand whose sinuses should therefore appear darker. For the recog-nition of pathology, it is essential to compare the two sides and tohave a fairly definite mental picture of the appearance of the normalsinus. In the study of the frontals both anteroposterior and lateralviews must be combined. 88 SKULL A general haziness with a sHght increase in density in one or moresinuses usually means thickening of the lining membrane. This maybe corroborated in the case of the frontals by the additional evidenceof thickening of the septal markings which become hazy and aresurrounded by an indefinite zone of slightly increased density, ascontrasted with the sharply outlined normal septa. This generalthickening may involve only one sinus, all of the sinuses on one side,. Fig. 63.—Osteoma of the frontal sinus. or those of both sides. In the last condition, some difficulty may arisefrom the fact that comparison of opposite sides is impossible and theroentgenologist must fall back upon his empirical knowledge ofwhat the normal should be. Granulations, pus or tumors produce a shadow of greater density,which usually obliterates the sinus completely. Their shadows areidentical in every respect, so that it is usually impossible to tell POLYPI 89 ^Yhich one we are dealing with from the roentgen plate alone. Whenthere is a fluid exudate in a sinus it is often possible to make out afluid level in the suspected cavity upon a plate taken with the patientupright. However, the absence of a fluid level does not rule out of the sinuses will ordinarily give some evidence of theirnature by erosion or invasion of the walls or adjacent bones, ^eryrarely a sinus or portion of the orbit will
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