Presentation
Headache for 15 months. Right side proptosis for one week. Normal thyroid profile.
Patient Data
The patient had only a headache when the CT was taken.
Abnormal enlargement of the right medial and lateral rectus muscles and the left medial rectus muscle is seen.
Abnormal enlargement of the right superior, medial, and lateral rectus muscles is noted (intermediate signal on T1WI, T2WI, and post-contrast avid enhancement). There is extrinsic compression of the right globe and resultant proptosis. The right globe is otherwise normal with an intact lens. The optic nerve is also intact.
The left medial rectus muscle is also bulky.
There is no intracranial abnormality.
Case Discussion
As the thyroid profile of the patient was normal, it was diagnosed as an orbital pseudo-tumor (idiopathic orbital inflammation). The patient was put on prednisolone, and a dramatic response was seen. The proptosis resolved in 5 days.
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