Sinus X-ray

About direction

A sinus X-ray is a quick picture of the facial bones. It shows if your sinuses hold air, fluid, swollen lining or a cyst. It takes a few minutes. No pain, no prep, and a small radiation dose. An ENT doctor usually orders it when they suspect maxillary sinusitis or another sinus infection. At Oberig Clinic the X-ray is done in the Diagnostic Department, and radiologists read the image.

What a sinus X-ray shows

Sinuses are air-filled spaces in the skull bones around the nose. The largest are the maxillary sinuses in the cheeks. The frontal sinuses sit above the eyes, the ethmoid sinuses between them, and the sphenoid sinus lies deeper. On the image, air looks dark. Bone, fluid and thick lining look light. That contrast is what reveals inflammation.

The doctor checks how clear each sinus is and compares left with right. The image can show a thickened lining along the walls, a flat fluid level, a sinus that is fully blocked, round cysts with smooth edges, foreign bodies such as filling material after dental work, and fractures after an injury. A referral may say "PNS X-ray". It is the same test. PNS stands for paranasal sinuses. The frontal sinuses may need an extra view.

An X-ray has limits. Bones overlap on a flat image, so the ethmoid and sphenoid sinuses are hard to judge. Small polyps and the inside of the nasal passages do not show well either. For those, the ENT doctor uses an endoscope, a thin camera that looks straight into the nose, or orders CT. Think of the X-ray as a quick first answer to one question: is a sinus blocked or not?

When doctors order it

Typical reasons are a stuffy nose and discharge for more than 10 days, or pain and pressure in the cheeks, forehead or between the eyes that gets worse when you bend down. Others include headache, a fever that comes back after a cold seemed to clear, a bad smell from the nose and a weaker sense of smell. The X-ray either confirms sinusitis or sends the doctor looking for another cause.

It also helps to check treatment, with frequent flare-ups, after a facial injury, with a suspected cyst and before a sinus puncture. One catch. During a fresh cold, almost everyone has swollen sinus lining. That is not sinusitis yet. So without clear reasons, nobody X-rays the sinuses in the first days of a runny nose.

Some warning signs need a doctor the same day, not a planned X-ray: swelling or redness around the eye, double vision, a severe headache with high fever, a stiff neck. These can be complications of sinusitis. Call emergency care on 3003.

Normal sinus X-ray

In a healthy person all sinuses look dark and clear, much like the eye sockets next to them. The bony walls have smooth, sharp outlines. Left and right match. A small size difference is common and is not a disease. Neither is a slightly bent nasal septum, which most adults have to some degree.

Frontal sinuses vary a lot between people. Some are large, some small, some people have none at all. That is normal anatomy. So the radiologist looks at clarity and the walls, not size. A normal report says something like "sinuses are well aerated, no pathological changes".

When something is wrong, the wording changes. "Mucosal thickening" means swollen or chronically inflamed lining. "Reduced aeration" means the sinus is less clear than it should be. "Subtotal" or "total opacification" means most or all of the sinus is filled. "Air-fluid level" means fluid or pus has collected. Each term describes the picture. It is not a diagnosis. Your ENT doctor makes the diagnosis.

Sinusitis on X-ray

In acute maxillary sinusitis, the sinus turns partly or fully white because swelling and fluid have replaced the air. When you sit upright, the fluid settles into a flat line, and the image shows a sharp horizontal edge. That is a typical sign of bacterial sinusitis with pus. In chronic disease you more often see thick lining along the walls, sometimes polyps.

A cyst looks like a round shadow with a smooth edge, usually on the floor of the maxillary sinus. It is often a chance finding and needs no treatment. The ENT doctor reads the image together with your symptoms and an exam. An X-ray shows a blocked sinus, but it cannot always tell pus from swelling or a cyst.

Sinusitis can also start from a tooth. The roots of the upper back teeth sit very close to the floor of the maxillary sinus. An infected tooth, or one recently pulled, can spread infection into the sinus. Clues are trouble on one side only, a bad smell and recent dental work. Treatment involves a dentist too, because the sinus keeps getting reinfected until the tooth is fixed. A fungal ball often shows as a dense shadow with tiny calcium specks, and CT shows it better.

Types of sinusitis

Sinusitis is any inflammation of a sinus. Maxillary sinusitis, in the cheek, is the most common. Frontal sinusitis causes pain above the eyebrows that is worse in the morning and when you bend. Ethmoid sinusitis, between the eyes, is common in children. Sphenoid sinusitis sits deep in the skull, causes pain at the back or top of the head and is hard to see on a plain X-ray. When several sinuses are involved, doctors call it pansinusitis.

By length, sinusitis can be acute (up to 4 weeks), subacute or chronic (over 12 weeks). Acute viral sinusitis usually clears on its own in 7 to 10 days. Doctors suspect a bacterial infection when symptoms last over 10 days or get worse again after improving. That is when an X-ray helps most.

Allergies play a part too. People with hay fever or year-round allergies often have swollen lining on both sides at once, with no fluid level. The X-ray then points the doctor towards allergy treatment rather than antibiotics, and that saves you a course of pills you do not need.

X-ray, CT or MRI

An X-ray is the first and simplest step. For a detailed view the ENT doctor orders a sinus CT. It is the gold standard before surgery. How they compare:

Question	X-ray	CT	MRI
Acute sinusitis, treatment check	enough	with complications	rarely
Chronic sinusitis, polyps, anatomy before surgery	too little detail	first choice	adds detail
Cysts, tumors, soft tissue	suspicion	good	best for soft tissue
Ethmoid and sphenoid sinuses	poorly seen	good	good
Radiation	minimal	more	none

What happens during the X-ray

No prep. You can eat, drink and take your medicines. Here is how it goes:

take off glasses, earrings, hair clips and removable dentures,
if you are or might be pregnant, tell us,
you sit or stand at the machine, rest your chin and nose on a support and open your mouth slightly,
hold your breath for a few seconds and stay still while the image is taken,
if needed, the technician takes one more view, for example for the frontal sinuses.

There is a reason you sit. Only upright does a fluid level show up. The whole thing takes a few minutes. If you cannot sit, we take the image lying down. Fluid levels are harder to see then, and the radiologist will keep that in mind.

After the X-ray

The ENT doctor prescribes treatment after an exam. Acute sinusitis often needs only drops, rinses and, if indicated, an antibiotic. If pus blocks a sinus, a displacement rinse of the nose and sinuses or a maxillary sinus puncture with drainage helps. Chronic sinusitis with polyps, cysts or a bent septum that blocks drainage may call for endoscopic surgery. CT always comes first. It gives the surgeon a precise map of your sinus anatomy.

A repeat X-ray after treatment is not always needed. Doctors order it if symptoms remain or the problem is chronic, usually after 2 to 3 weeks. The lining heals more slowly than symptoms fade.

Common questions

What does pus look like on the image?

Pus gives a white area with a flat top edge, like water in a glass. Swollen lining looks different: a light band along the walls with no sharp level.

Is a sinus X-ray harmful?

The dose is tiny, about a few days of natural background radiation. A repeat image to check treatment is fine.

Do children have sinus X-rays?

In young children the sinuses are still forming, so an X-ray often shows little. A pediatric ENT doctor may choose sinus ultrasound or endoscopy instead, and order an X-ray for an older child when needed.

What if the image shows a cyst?

Most maxillary sinus cysts are harmless and need no treatment. If a cyst is large, blocks breathing or causes pain, your ENT doctor will discuss endoscopic removal.

Can I get a sinus X-ray without a referral?

Adults can. A referral helps, but it is not required. The best plan is to combine the X-ray with an ENT visit on the same day. The doctor looks at the image, checks your nose with a scope, and you do not have to come back.

Is it safe in pregnancy?

Only for strict medical reasons. Tell us about pregnancy in advance, and the doctor will choose the safest option.

When will I get the results?

You get the report and image within 24 hours, except on weekends and public holidays.

Sinus X-ray price

One sinus X-ray costs UAH 1,295. If you need more detail, the doctor will order CT or MRI. Related tests and an ENT visit with endoscopy are in the table.

Service	Price
Sinus X-ray	UAH 1,295
Skull X-ray, two views	UAH 1,605
Head CT (one area, including sinuses)	UAH 2,780
Sinus and nasal cavity MRI, 1.5 T	UAH 3,695
ENT visit with endoscopy	UAH 1,790

Prices are from the clinic price list as of 01.10.2026 and may change. Please check the current price with our contact center before your visit.

Why choose Oberig Clinic

Tests and treatment in one place. X-ray, CT, MRI and an ENT exam in a single visit.
Experienced ENT doctors. Iryna Zarytska, PhD, Tamila Savchenko, PhD, associate professor, and Borys Myroniuk, PhD.
Storz video endoscopy. The ENT room has rigid and flexible scopes, so the doctor sees your sinuses from the inside as well as on an image.
Radiologist report. Doctors of the Diagnostic Department read the images. Results come within 24 hours.

Book an X-ray together with an ENT visit. Address: 3 Zoolohichna St, buildings "G" and "V", Kyiv. Book online at https://my.oberig.ua/ua/appointment/ or call +38 044 521 30 03.