6 year old male, evaluate extent of orbital cellulitis. MRI BRAIN: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The right maxillary sinus, right anterior ethmoidal air cells and right nasal cavity are completely filled by extensive T2/FLAIR signal. The skull and scalp soft tissues are grossly unremarkable.MRI ORBIT: There are inflammatory changes within the periorbital soft tissues as well as along the soft tissues overlying the right nasal ala and maxillary bone. There is complete opacification of the right maxillary sinus, right anterior ethmoidal air cells and right nasal cavity.There is a rim-enhancing collection along the inferomedial wall of the right orbit measuring about 5 x 5 mm in the axial plane (series 1201, image 5). Both orbits are otherwise intact. No intraconal or extraconal space mass is identified. The extraocular muscles are intact. The lacrimal glands are symmetric and within normal limits in size and configuration. There is no optic nerve enhancement appreciated. The suprasellar cistern is intact .
1. Right periorbital cellulitis with a small 5 mm rim-enhancing collection along the inferomedial wall of the right orbit which could represent a small subperiosteal abscess. No intracranial extension.2. Extensive right maxillary, anterior ethmoidal air cells and right nasal cavity opacification. Findings were discussed with Dr. Nishitani by phone on 12/24/2016 at 10:05 AM.