Teardrop sign of orbital blowout fracture

Case contributed by Dr Sumit Verma

Presentation

Patient presented to hospital after being assaulted. He was punched and kicked numerous times to the face. Nil LOC or symptoms of increased intracranial pressure. On examination, he had significant swelling around the left peri-orbital and maxillary region with marked tenderness in these regions as well.

Patient Data

Age: 30 years
Gender: Male

There is a depression of the left orbital floor in keeping with an undisplaced fracture and a pathognomic "teardrop sign" is present.

Additional minimally displaced fracture seen at the lateral wall of the left maxillary sinuses with a fluid level at the left maxillary sinus

Corresponding CT head confirming left orbital blowout fracture (best viewed on the coronal bone window) as well as the marked extent of soft tissue swelling seen on other projections.

Case Discussion

Teardrop sign can be seen sometimes on plain radiographs in an orbital blowout fracture. It is a polypoid soft tissue opacity seen hanging from the orbital floor into the maxillary antrum and represents inferior herniation of orbital contents, peri-orbital fat and inferior rectus muscle.

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Case information

rID: 74101
Published: 11th Feb 2020
Last edited: 11th Feb 2020
Inclusion in quiz mode: Excluded

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