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What is the main abnormality?
Marked enlargement and low density change of the extra-ocular muscles.
What condition can look somewhat similar but does not spare the musculotendinous junction?
Orbital pseudotumour.
Selected images from a non-contrast CT of the orbits demonstrates marked enlargement of the extraocular muscles which spares the tendinous insertions. The belly of the muscles also demonstrate low attenuation change. The inferior rectus is most severely affected. The result is significant proptosis.