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12 Y/O Male with Periorbital Cellulitis
This CT case shows a 12-year-old male with periorbital cellulitis, later confirmed to have a subperiosteal orbital abscess—a surgical emergency often seen in children as a complication of sinusitis.
Imaging Features:
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Axial soft tissue CECT reveals a rim-enhancing fluid collection near the medial orbital wall.
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Bone window CT demonstrates no frank bony erosion, but adjacent sinus disease is clear.
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Findings indicate a subperiosteal abscess, caused by the spread of ethmoid sinusitis through the lamina papyracea, even when no defect is visible.
Clinical Insight:
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This abscess does not breach the periosteum, remaining trapped and displacing the medial rectus muscle laterally.
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It is a surgically treated condition and must be distinguished from orbital cellulitis without abscess formation.
Case courtesy of Barton Branstetter, MD
University of Pittsburgh