Preliminary Diagnosis: Orbital Cellulitis
I. What imaging technique is first-line for this diagnosis?
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Contrasted CT of the brain and orbits.
II. Describe the advantages and disadvantages of this technique for diagnosis of orbital cellulitis.
Advantages
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Relatively inexpensive and fast imaging modality
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Better able to detail any associated osseous abnormality than other imaging modalities
Disadvantages
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Exposes a patient to ionizing radiation
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Less exquisite detail of the adjacent soft tissues including the orbit, optic nerves, extraocular muscles, and lacrimal glands
III. What are the contraindications for the first-line imaging technique?
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May be contraindicated in pregnant patients
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Relative contraindication in patients with allergy to contrast
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Relative contraindication in patients with renal failure
IV. What alternative imaging techniques are available?
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Contrasted MR of the brain and orbits.
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of orbital cellulitis.
Contrasted MR of the Brain and Orbits
Advantages
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Offers exquisite detail of the adjacent soft tissues and better characterizes and details intracranial extension
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Does not expose the patient to ionizing radiation
Disadvantages
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Expensive
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Time consuming
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Requires significant patient cooperation to minimize motion artifact
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Less adept at detailing any associated osseous involvement
VI. What are the contraindications for the alternative imaging techniques?
Contrasted MR of the Brain and Orbits
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Contraindicated in patients with non–MR-compatible hardware
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