Question

A patient presented with history of diplopia and restricted eye movements. A clinical image and CT image is shown below. What will be the diagnosis?

• A. Le- fort fracture
• B. Fracture maxilla
• C. Fracture zygomatic
• D. Blow out fracture

Answer 1

The Correct Option is D

The diagnosis of a "blow out fracture" aligns with the presented symptoms and the imaging findings. A blow out fracture refers to the fracture of one or more of the bones surrounding the eye, typically occurring as a result of trauma to the face. It often involves the orbital floor or medial wall. Here, we explore the reason for this diagnosis:

• Symptoms: The patient experiences diplopia (double vision) and restricted eye movements. These symptoms are common in blow out fractures due to muscle entrapment or nerve damage.
• Imaging: CT images typically show bony discontinuity, often in the orbital floor or medial wall, along with potential herniation of orbital contents. These findings are pathognomonic for a blow out fracture.
• Diagnostic Clarification: In contrast, a Le Fort fracture involves the maxillary bones, presenting with different patterns of maxillofacial disruption on imaging. A maxilla fracture would often show structural damage specific to the maxillary bone, not localized to orbital structures. A zygomatic fracture involves the zygoma bone, characterized by different visual and structural deformities around the cheek area.

Based on the combination of clinical symptoms and specific imaging features (typically detailed in radiological exams), the most fitting diagnosis is a blow out fracture.