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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2022; 41(01): e7-e13
DOI: 10.1055/s-0041-1740175
Original Article

Differential Diagnoses of Diseases Involving the Extrinsic Ocular Musculature – A Pictorial Essay[*]

Diagnóstico diferencial das doenças que envolvem a musculatura ocular extrínseca – Um ensaio pictórico*
Larissa Marques Santana 
1   Department of Radiology, Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo, Vitória, Brazil
,
Larissa de Aguiar Martins 
1   Department of Radiology, Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo, Vitória, Brazil
,
Marcos Rosa-Júnior 
2   Department of Neuroradiology, Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo, Vitória, ES. Brazil
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Abstract

Introduction There are some inflammatory, infectious, and neoplastic diseases affecting the extrinsic orbital musculature (EOM) that present with pain, decreased visual acuity, and proptosis. Imaging is fundamental to the differential diagnoses of these diseases with similar clinical presentations. The present case series report has as main objective to illustrate and discuss the main pathologies that affect the orbit.

Material and Methods The present series of cases discusses the main pathologies that can affect the extraocular musculature that can be characterized by computed tomography (CT) or magnetic resonance imaging (MRI) using cases from our institution.

Results and Discussion The present study compiled several cases of ophthalmopathy from our institution to illustrate and address some of these pathologies, such as orbital lymphoma, Grave disease, metastases, periorbital cellulitis, and idiopathic orbital inflammatory syndrome. The diseases are discussed according to the presentation of clinical cases with emphasis on the main imaging findings of each pathology.

Conclusion Computed tomography and MRI can help in the diagnosis and follow-up of the diseases that affect the EOM. We must be conversant with the main characteristics of the pathologies presented in the present case series report, since such findings together with clinical data can confirm the diagnosis of these diseases or at least help to narrow the differential diagnoses.

Resumo

Introdução Existem algumas doenças inflamatórias, infecciosas e neoplásicas que afetam a musculatura orbitária extrínseca que se apresentam com dor, diminuição da acuidade visual e proptose. Exames de imagem são fundamentais para o diagnóstico diferencial dessas doenças com apresentações clínicas semelhantes. A presente série de casos tem como principal objetivo ilustrar e discutir as principais patologias que afetam a órbita.

Material e métodos A presente série de casos discute as principais patologias que podem afetar a musculatura extraocular passíveis de caracterização por estudo de tomografia computadorizada (TC) ou de ressonância magnética (RM) utilizando casos próprios da nossa instituição.

Resultados e discussão O presente estudo compilou diversos casos de oftalmopatia da nossa instituição para ilustrar e abordar algumas destas patologias, como linfoma orbital, doença de Grave, metástases, celulite periorbital e síndrome inflamatória orbital idiopática. As doenças são discutidas de acordo com a apresentação dos casos clínicos, dando-se ênfase nos principais achados de imagem de cada patologia.

Conclusão A TC e a RM auxiliam no diagnóstico e no acompanhamento das doenças que acometem a musculatura ocular extrínseca. Deve-se estar familiarizado com as principais características das patologias apresentadas na presente série de casos, uma vez que tais achados, juntamente com os dados clínicos, podem confirmar o diagnóstico destas doenças ou, pelo menos, ajudar a estreitar os diagnósticos diferenciais.

Keywords

graves ophthalmopathy - orbital lymphoma - orbital pseudotumor - orbital cellulitis - sarcoidosis

Palavras-chave

orbitopatia de graves - linfoma orbital - pseudotumor orbital - celulite orbital - sarcoidose

Ethics Approval and Consent to Participate

Ethical approval was provided by the HUCAM Institutional Review Board (CAAE - 08119819.8.0000.5071), Brazil.


Availability of Data and Materials

The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request. All data generated or analyzed during the present study are included in the present published article (and its supplementary information files).


Contributions of the Authors

Santana L. M. and Rosa-Junior M analyzed and interpreted the patient data regarding CT and MRI and were major contributors in the writing of the manuscript. Martins L. A. analyzed and interpreted the patient data regarding CT and MRI and made the figure slides. All authors read and approved the final manuscript.


* These authors contributed equally to the manuscript.




Publication History

Received: 23 March 2021

Accepted: 30 July 2021

Article published online:
14 January 2022

© 2022. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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