A 45 year old female with proptosis and periorbita

Images

Doctor's Information

Name :  Sophia
Family :Saboori
Affiliation : ----------------
Academic Degree: ----------------
Email :  ----------------
Resident :  Farhad Niaghi

Patient's Information

Gender : Female
Age : 45

Case Section

Head & Neck Imaging

Clinical Summary

A 45 year old female with proptosis and periorbital swelling.

Imaging Procedures and Findings

Fusiform enlargement of inferior and medial and superior recti muscles are noted. Increased intra-orbital fat accompanied by proptosis is present. Periorbital soft tissue swelling is present.

Discussion

Thyroid-associated ophthalmopathy is an autoimmune-mediated inflammation of the extraocular muscles and periorbital connective tissues. It is most often associated with Graves' disease, although association with other thyroid diseases such as Hashimoto's thyroiditis, thyroid carcinoma, and neck irradiation has also been reported. The classic imaging findings are fusiform enlargement of the extraocular muscles with sparing of the tendinous attachments (which may be difficult to appreciate when muscle enlargement is severe), and inflammatory changes of the periorbital fat. There may be increase of the intraorbital fat. The lacrimal glands may also be affected. The extraocular muscles most often affected, in descending order of frequency, are the inferior rectus, medial rectus, and superior rectus-levator palpebrae muscle complex. Periorbital soft tissue swelling and proptosis may be seen. Involvement is usually bilateral but may be asymmetrical. Direct involvement of the globe and optic nerve sheath is uncommon.

Final Diagnosis

Thyroid-Associated Ophthalmopathy

References

CT and MR imaging of the whole body / [edited by] John R. Haaga ... et al.].-5th ed p.482