Imaging of the orbits, paranasal sinuses and brain ( ideally with contrast ) is a very important radiological emergency in selected patients, typically children, with orbital cellulitis.
The scan has three chief purposes:
1. Is there a subperiosteal collection?
2. It there any intracranial extension?
3. Is there underlying severe sinusitis?
This case shows the typical 'positive' scan - a subperiosteal collection, which warrants prompt treatment to prevent any threat to vision.
Emergency fiber optic endoscopic surgery was performed - pus drained from the maxillary and ethmoidal sinuses.