Orbital cellulitis with subperiosteal collection

Case contributed by Ian Bickle
Diagnosis certain


OMF junior calls to ask for CT after discussion with an ophthalmologist. Swollen eyes believed to be from a dental origin.

Patient Data

Age: 15 years
Gender: Female

Left-sided pre-septal soft tissue swelling and subcutaneous inflammatory change. 

Thin elliptical subperiosteal collection in the left medial extra-conal space adjacent to the lamina papyracea.  Irregularity of the lamina without frank destruction.

Extraconal soft-tissue-fluid attenuation abnormality in the superolateral of the left orbit causing proptosis and inferior displacement of the globe.

The left frontal and ethmoidal sinuses are opacified with fluid.

No intracranial extension.

Case Discussion

The typical appearances of a subperiosteal collection ethmoidal sinus disease presenting as an orbital cellulitis.

This is a pediatric eye emergency, with urgent collection drainage merited.

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