Levator palpebrae superioris (LPS) myositis

Case contributed by Dr Luke Danaher

Presentation

Left periorbital swelling. Proptosis. Chemosis. Not responding to flucloxacillin.

Patient Data

Age: 70
CT

CT orbits (with contrast)

Left orbit

  • periorbital edema
  • preseptal fat stranding
  • post-septal, extraconal stranding
  • exopthalmos
  • levator palpebrae superioris (LPS) markedly enlarged
  • LPS enhancement

 

MRI

MRI orbits (with contrast)

Left orbit

  • periorbital edema
  • preseptal fat stranding
  • post-septal, extraconal stranding
  • exopthalmos
  • levator palpebrae superioris (LPS) markedly enlarged
  • LPS enhancement
  • superior rectus muscle displaced inferiorly

Case Discussion

  • patient presented with marked periorbital edema
  • treated empirically with oral antibiotics
  • this didn't respond and a CT demonstrated marked orbital edema and LPS swelling
  • MRI was performed to exclude an enhancing mass, collection, or myositis
  • MRI confirmed LPS myositis
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Case information

rID: 42494
Published: 23rd Jan 2016
Last edited: 23rd Jan 2016
System: Head & Neck
Inclusion in quiz mode: Included

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