IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Acute otitis media: bulging tympanic membrane

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Severe right ear pain and tenderness over the right mastoid process ? mastoiditis

Patient Data

Age: 6 years
Gender: Male

Fluid in the middle ear cleft on the right as well as the mastoid antrum and mastoid air cells.  No overlying soft tissue swelling nor bone erosion to indicate osteomyelitis/gross mastoiditis. Note bulging of the upper tympanic membrane (pars flaccida) due to raised pressure in the tympanic cavity with pulling in at the umbo ie the malleolal attachment. Note the inferior pars tensa portion of the membrane does not bulge as dramatically as the upper flaccida.

Note bulging of the upper tympanic membrane (pars flaccida) due to raised pressure in the tympanic cavity (arrow) with pulling in at the umbo ie the malleolal attachment.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.