Presentation
Recent trauma to the right orbit with a tree branch.
Patient Data
A 6 x 5 mm well-defined hyperdense focus just superior to right superior rectus muscle (extraconal space) is visible. Mild inflammatory change around this lesion is notable.
Right preseptal cellulitis is seen.
Right globe and right optic nerve in the retrobulbar area appear normal.
6 x 5 mm T1 hyperintense and T2 hypointense lesion with peripheral edema and minimal fluid accumulation just superior to right superior rectus muscle without enhancement on the postcontrast study. No extraconal space collection is detected.
Right-sided preseptal cellulitis is also notable. Mild proptosis of the right globe is seen.
Otherwise, the exam is unremarkable.
Case Discussion
Based on the imaging findings and the recent history of penetrating trauma, a foreign body (a piece of wood) was the final diagnosis.
A CT scan of the orbit is the modality of choice, as it provides superior localization of small foreign bodies, the anatomy of the surrounding structures, and any associated injuries. Unlike MRI, it may be used in the detection of a metallic foreign body 1.