Eyes open in orbital evaluation: a review of normal anatomy and findings in urgent CT of infectious and traumatic pathology

Congress:

ECR 2020

Poster Number:

C-05481

Type:

Educational Exhibit

Keywords:

Not applicable, Trauma, Infection, Acute, Education, CT, Eyes, Emergency, Anatomy, Emergency Imaging

Authors:

J. Cisternas Bittencourt¹, A. Estremera Rodrigo¹, R. ALARCON¹, C. Sánchez García¹, A. M. AVILA VENEGAS²; ¹PALMA DE MALLORCA/ES, ²PALMA , ISLAS BALEARES/ES

DOI:

10.26044/ecr2020/C-05481

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-05481

Fig. 20: CE-CT of a 68-year-old man who complained of swelling and redness of the...

Fig. 8: NE-CT of an 81-year-old woman who suffered a fall. After initial clinical...

Fig. 1

$Fig. 4: 3D rendering of a right blow-out orbital fracture involving the lateral wall and floor of the orbit. References: Servicio de Radiodiagnóstico, Hospital Universitario Son Llàtzer, Palma de Mallorca / España 2020$

Fig. 4: 3D rendering of a right blow-out orbital fracture involving the lateral wall...

Fig. 14: NE-CT of a 44-year-old man that presented with trauma to the right eye and a...

Learning objectives

To review the normal antomy of the bony orbit, globe and supporting structures. To streamline the diagnosis of traumatic and infectous pathology in the emergengy setting through imaging, specifically with Computed Tomography.

Background

The orbits are complex structures that contain the globeand supporting muscular, vascular and nervous structures, connective tissue and most of the lacrimal glands, constituting the sensory apparatus for sight. While there are anatomical barriers to protect them, they are nonetheless susceptible to a variety of pathologies, including those of infectious and traumatic aetiologies. Computed Tomography is an excellent radiological tool that allows diagnosis in a large majority of cases presenting in the emergency setting, allowing clinicians to streamline medical decisions.

Findings and procedure details

I. Anatomical Review Bone The orbits are symmetrical, pyramid-shaped sockets located anteriorly in the skull. Each is bounded by the periosteum of seven cranial bones with an open, anterolateral base and a posteromedially directed apex. The orbit has a rim and four wallsthat separate it from other cranial structures: Roof: frontal bone and lesser wing of the sphenoid; above it are the frontal sinus and anterior cranial fossa. Includes the supraorbital notch (supraorbital vessels and nerve), and anterolaterally the lacrimal gland fossa. Lateral wall: formed...

Conclusion

Due to the frequency of orbital pathology, it is imperative that radiologists are well-acquainted with the complex regional anatomy and the common findings to expect and look for in the setting of infection or trauma. This poster has aimed to compile, through illustrations and CT images, a review of the normal anatomy and of these pathologies and their findings.

Personal information and conflict of interest

J. R. Cisternas Bittencourt contact at: [email protected] A. Estremera Rodrigo R. Alarcón Cano C. Sánchez García A. M. Avila Venegas All authors have nothing to disclose. Hospital Universitario Son Llàtzer Servicio de Radiodiagnóstico Palma de Mallorca, Islas Baleares / ES

References

Som PM, Curtin HD (2003). Head and Neck Imaging (4th Edition). Mosby. del Cura JL, Pedraza S, Gayete A, Rovira A (20019). Radiología Esencial (2da Edición). Panamericana. Nguyen VD, Singh AK, Altmeyer WB, Tantiwongkosi W. Demystifying Orbital Emergencies: A Pictorial Review. RadioGraphics. 2017; 37: 947-962. Kubal, WS. Imaging of Orbital Trauma. RadioGraphics. 2008; 28: 1729-1739. LeBedis CA, Sakai O. Nontraumatic Orbital Conditions: Diagnosis with CT and MR Imaging in the Emergent Setting. RadioGraphics. 2008; 28: 1741-1753.