Case of the Month 2016-02, Page 3

Answer: A, B, C, and D

All of the options are potential complications associated with acute sinusitis. Infection can spread from the sinuses to adjacent structures, including the orbits and the intracranial contents. Sometimes osseous destruction can be seen between two sites of infection, but oftentimes the separating bone appears normal on cross-sectional imaging; one theory is that infection can spread through the Haversian canals of the bones to reach another site.

Now that you are aware of some of the complications, you take a closer look at additional images in the CT scan:

For larger images, please click on Head Pain 3 and Head Pain 4 .

These two images demonstrate a rim-enhancing fluid collection superomedial to the right eye. There is a small focus of air in this fluid collection, and this finding is pretty much definitive for an abscess.

Which of the following terminologies best categorize this abscess?

  • Preseptal, intraconal
  • Preseptal, extraconal
  • Postseptal, intraconal
  • Postseptal, extraconal
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