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A systematic approach to CT evaluation of orbital trauma

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Abstract

Computed tomography (CT) is widely used in the initial evaluation of patients with craniofacial trauma. Due to anatomical proximity, craniofacial trauma often involves concomitant injury to the eye and orbit. These injuries may have devastating consequences to vision, ocular motility, and cosmesis. CT imaging provides a rapid and detailed evaluation of bony structures and soft tissues of the orbit, is sensitive in detection of orbital foreign bodies, and often guides clinical and surgical management decisions in orbital trauma. For this reason, radiologists should be prepared to rapidly recognize common orbital fracture patterns, accurately describe soft tissue injuries of the orbit, detect and localize retained foreign bodies within the globe and orbit, and recognize abnormalities of the contents and integrity of the globe. In this review, we present a systematic approach to assist radiologists in the rapid evaluation of orbital trauma using the “BALPINE” mnemonic—bones, anterior chamber, lens, posterior globe structures, intraconal orbit, neurovascular structures, and extraocular muscles/extraconal orbit. Using this approach, we describe common traumatic findings within each of these spaces, and present common postsurgical appearances that can mimic findings of acute trauma.

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Authors and Affiliations

  1. Department of Radiology, University of Cincinnati Medical Center, 234 Goodman St., Cincinnati, OH, 45267, USA

    Aaron M. Betts

  2. Department of Radiology, San Antonio Military Medical Center, Fort Sam, Houston, TX, USA

    Aaron M. Betts

  3. Department of Radiology, Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base, TX, USA

    Aaron M. Betts & William T. O’Brien

  4. Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    William T. O’Brien

  5. Department of Ophthalmology, University of Colorado Hospital, Aurora, CO, USA

    Brett W. Davies

  6. Audie L. Murphy Division, Ophthalmology Service, South Texas Veterans Health Care System, San Antonio, TX, USA

    Omaya H. Youssef

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  1. Aaron M. Betts
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Betts, A.M., O’Brien, W.T., Davies, B.W. et al. A systematic approach to CT evaluation of orbital trauma. Emerg Radiol 21, 511–531 (2014). https://doi.org/10.1007/s10140-014-1221-5

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