![]() ![]() Idiopathic Sclerotic Inflammation of the Orbit with Left Optic Nerve Compression in a Patient with Multifocal Fibrosclerosis. Schaffler G, Simbrunner J, Lechner H et al. G ranulomatosis with polyangiitis: bilateral involvement of the paranasal sinuses and orbits associated with osseous destruction Tolosa-Hunt syndrome: related condition with the involvement of the cranial nerves in the cavernous sinus and resulting ophthalmoplegia T hyroid-associated orbitopathy (TAO): spares the tendinous insertions and not usually painful O rbital cellulitis: usually associated with a subperiosteal abscess from adjacent sinusitis or with a previous history of trauma/dental procedure Other imaging differential considerations include: However, orbital lymphoma usually presents as a progressive orbitopathy rather than acutely, is more often bilateral, shows lower values on ADC, and does not respond to corticosteroid. There is considerable overlap between these entities both clinically and radiologically. One of the main differential diagnoses of idiopathic orbital inflammation is orbital lymphoma. They also introduced the term orbital pseudotumor afterward in 1930 7. The disease was first described by Birch-Hirschfeld et al. A degree of residual fibrosis can be demonstrated, especially in the more refractory cases. Most cases resolve rapidly with treatment (usually corticosteroids suffice) although in a subset with more chronic progression chemotherapy and radiotherapy may be required. T1 C+ (Gd): moderate to a marked diffuse enhancement T2: affected region typically hypointense due to fibrosis and with more progression of fibrosis it becomes more hypointense, but the signal can also be iso- to hyperintense to extra-ocular muscles 2 ![]() T1: affected region typically isointense (to extraocular muscles) 1 but can also be hypointense 1-3 It is most commonly unilateral but can be bilateral in 25% of cases. Extension into the cavernous sinus, meninges, and dura can occur. ![]() It can appear as an infiltrative mass and extends outside of the orbit via superior or inferior orbital fissures. However, sparing of the anterior tendon does not exclude the diagnosis of idiopathic orbital myositis 7.Īdditional inflammation can be seen in surrounding tissues, including the orbital fat, lacrimal gland, and optic nerve sheath. Involvement of the tendinous insertion distinguishes the idiopathic orbital inflammation from thyroid-associated orbitopathy (TAO) in which the insertion point is spared. Imaging demonstrates enlargement of the muscle belly of one (or more) extraocular muscles typically with the involvement of tendinous insertions. I gG4-related disease, now recognized as a separate entity: IgG4-related orbital disease The condition has been associated with other inflammatory and autoimmune conditions: Optic perineuritis: involvement of the optic nerve sheathĭiffuse pseudotumor: affecting multiple compartments Myositic pseudotumor (myositis): predominantly involves the extraocular muscles and therefore mimic thyroid-associated orbitopathy (TAO) but unlike TAO it also involves the tendons Posterior pseudotumor: in the fat at the orbital apex distinguished from Tolosa-Hunt syndrome in that the cavernous sinus is spared Classificationĭivision into a number of subgroups according to location has been proposed:Īnterior pseudotumor: in the immediate retrobulbar fat space industry.Histologically acute lesions demonstrate lymphocytes (which can be mistaken for orbital lymphoma), plasma cells, and giant cell infiltration. The failure was a disappointment for Virgin Orbit and British space officials, who had high hopes that the launch would mark the beginning of more commercial opportunities for the U.K. In January, a mission by Virgin Orbit to launch the first satellites into orbit from Europe failed after its LauncherOne rocket's upper stage experienced "an anomaly" that caused it to prematurely shut down, according to the company's website. ![]()
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