Which sign differentiates acute sinusitis from viral rhinitis?

• A. fever
• B. rhinorrhea
• C. facial pain
• D. swollen nasal mucous membranes

Answer: (C)

Acute sinusitis shows facial pain or pressure that is localized to the affected sinus and often accompanied by tenderness over the sinus areas. This focal sinus tenderness is not typical of viral rhinitis, whose symptoms are more diffuse (rhinorrhea, nasal congestion, sneezing, sore throat, and cough) without targeted facial tenderness. Fever can occur with either illness, so it isn’t a reliable differentiator, and swollen nasal mucosa or rhinorrhea are common to both. So the key distinguishing sign is facial pain/pressure due to sinus involvement.