Penetrating Orbital Injury, MR
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0283-Penetrating Orbital Injury, MR
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CA0283-Penetrating Orbital Injury, MR
Case ReportHistory
Exam
Prior Study
Findings
Preseptal Soft tissues and Orbital Adnexa
The right preseptal soft tissues including the eyelid, conjunctival sac and lacrimal gland and sac are swollen/edematous. There is likely and infected tract extending to the skin surface in the right mesial supraorbital region. There are possible small collections of air bubbles on the right within the preseptal and postseptal soft tissues.
There is an obviously linear low signal intensity foreign body best traced on series 7 from the area of preseptal soft tissue swelling along the area of the lacrimal sac and below the medial canthus continuing to the post septal soft tissues along the mesial margin of the medial rectus muscle. This linear low signal intensity structure is a likely foreign body composed of organic material and/or coated with blood.
Eyes and Optic nerves
The right eye is not decompressed or enlarged. The right anterior segment is normal.
There is no evidence of evidence of a subretinal, subchoroidal, subhyaloid or intravitreous hemorrhage or other fluid collection.
The junctions of the optic sheath/nerve and eye are normal. There is minimal abnormal enhancement of the distal optic sheath.
Proptosis is present on the right. The optic sheath/nerve has a minimally stretched appearance but the posterior aspect of the globe is not tented in appearance. Signs of tension orbit are not present.
Orbits
There is gas (low intensity) bubbly pattern and a possible tract suggesting infection along a path of a likely penetrating injury. The extraconal and intraconal orbital fat is edematous and hypervascular strongly consistent with orbital cellulitis. The right medial rectus and superior oblique muscles are very swollen but the orbital apex and superior orbital fissure remain normal.
The bones of the orbit including the optic canal are normal.
Brain
There are no intra-axial or extra-axial abnormalities of the brain that might be related to the eye/orbital pathology.
Other findings
There are no other significant abnormalities present. There is likely inconsequential chronic sinus disease.
