Male 6 years old Reason: orbital cellulitis, concern for intracranial involvement. ENT requesting orbital views History: Orbital cellulitis. There is diffusion restriction in the right maxillary sinus and scattered areas of restriction in the right posterior ethmoid air cells likely relating to pus. There is also near complete opacification of the right maxillary sinus, right anterior ethmoid air cells, and right frontal sinus. There is adjacent abnormal T2 hyperintensity and enhancement involving the medial extraconal fat of the right orbit. There is extraconal confluently enhancing tissue measuring approximately 5 x 16 mm (series 1201, image 9), without focal collection to suggest subperiosteal abscess. There is mild peripheral enhancement along the right medial rectus muscle, which is somewhat ill-defined but does not appear enlarged or asymmetrically enhancing. The majority of the inflammatory changes are seen anteriorly and the orbital apex is relatively clear. No evidence of intracranial extension of abnormal signal or enhancement to suggest intracranial extension of the infection.There is also partial opacification and mucosal thickening of the left maxillary sinus. The major cerebral flow voids are intact. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma 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.
1.Right post septal orbital cellulitis with a small probable phlegmon in the the medial extraconal fat and mild inflammatory changes of the medial rectus muscle. No evidence of intracranial extension of infection.2.Findings compatible with right anterior acute sinusitis.