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Acute sinusitis and orbital subperiosteal abscess

Case contributed by Ahmed Abdrabou
Diagnosis certain

Presentation

Left painful proptosis and ophthalmoplegia after an attack of acute sinusitis

Patient Data

Age: 25 years
Gender: Male

Left frontal, ethmoid and maxillary sinusitis. There is an elliptical fluid collection at the medial aspect of the left orbit, extraconal in location and displacing the medial rectus laterally. It displays diffusion restriction and marginal enhancement. The cavernous sinus is not thrombosed. 

Arrows refer to the fluid collection at medial orbit with diffusion restriction as high signal on DWI and low signal on ADC.

Case Discussion

Acute sinusitis may be complicated by orbital subperiosteal abscess by spreading of infection through the lamina papyracea. The patient underwent abscess drainage surgically.

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