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Orbital Myositis

  • Leonid Skorin und Ross Francis English
Veröffentlicht/Copyright: 1. Februar 2014
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Journal of Osteopathic Medicine
Aus der Zeitschrift Journal of Osteopathic Medicine Band 114 Heft 2

A young gravid woman (G1P0) with a history of migraine headaches presented with severe right eye pain of 3 days duration that was worse with eye adduction. Ocular examination was significant for minimal anterior proptosis in the right eye with Hertel exophthalmometer measurements of 22 mm OD and 20 mm OS. Magnetic resonance (MR) image revealed an enlarged medial rectus muscle in the right eye (arrow) (width, 6.0 mm OD and 2.4 mm OS). Muscle thickening and increased signal intensity on T2-weighted MR image were consistent with acute orbital myositis. Oral prednisone (80 mg) was administered, followed by a 30-day taper of 20 mg every 5 days. The patient's symptoms resolved.

Orbital myositis is an idiopathic inflammatory disorder that usually manifests in the extraocular muscles, presents acutely, and is often unilateral.1 Signs and symptoms include proptosis, redness over the involved muscle, conjunctival chemosis, lid ptosis, eye pain that is worse with movement, and diplopia.1 Diagnosis is made according to clinical findings as well as extraocular muscle enlargement found on computed tomographic or MR images.1 Orbital myositis typically responds to corticosteroids; however, nonsteroidal anti-inflammatory drugs may be helpful in mild cases.2 Infliximab, a monoclonal antibody, or radiotherapy have been recommended if corticosteroids are unsuccessful.3

From the Mayo Clinic Health System in Albert Lea, Minnesota (Dr Skorin), and the Pacific University College of Optometry in Forest Grove, Oregon (Mr English). Mr English was a fourth-year optometry extern at the time of the present case
Address correspondence to Leonid Skorin Jr, DO, OD, MS, Mayo Clinic Health System, 404 W Fountain St, Albert Lea, MN 56007-2437. E-mail:

  1. Financial Disclosures: None reported.

References

1 Costa RM Dumitrascu OM Gordon LK . Orbital myositis: diagnosis and management. Curr Allergy Asthma Rep.2009;9(4):316-323.10.1007/s11882-009-0045-ySuche in Google Scholar PubMed

2 Yuen SJ Rubin PA . Idiopathic orbital inflammation: distribution, clinical features, and treatment outcome. Arch Ophthalmol.2003;121(4):491-499.10.1001/archopht.121.4.491Suche in Google Scholar PubMed

3 Garrity JA Coleman AW Matteson EL Eggenberger ER Waitzman DM . Treatment of recalcitrant idiopathic orbital inflammation (chronic orbital myositis) with infliximab. Am J Ophthalmol.2004;138(6):925-930.10.1016/j.ajo.2004.06.077Suche in Google Scholar PubMed

Received: 2013-07-13
Revised: 2013-08-06
Accepted: 2013-08-20
Published Online: 2014-02-01
Published in Print: 2014-02-01

© 2014 The American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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https://doi.org/10.7556/jaoa.2014.028
Creative Commons
BY-NC-ND 4.0

Artikel in diesem Heft

  1. Special Report
  2. It's All About the Footnotes: 2014 Vaccine Schedules
  3. Editorial
  4. AOA Names Mayo Clinic Academic Leader as New Editor in Chief
  5. Letters
  6. Leg Length Discrepancy and Osteoarthritic Knee Pain in the Elderly
  7. Response
  8. Original Contribution
  9. Sleep Problems, Posttraumatic Stress, and Mood Disorders Among Active-Duty Service Members
  10. OMT Associated With Reduced Analgesic Prescribing and Fewer Missed Work Days in Patients With Low Back Pain: An Observational Study
  11. Evidence-Based Clinical Review
  12. Preventing Early Cardiovascular Death in Patients With Familial Hypercholesterolemia
  13. Medical Education
  14. Mini–Medical School Programs Are an Effective Tool to Introduce Students to Osteopathic Medicine
  15. Special Communication
  16. The “Diplomate in Osteopathy”: From “School of Bones” to “School of Medicine”
  17. Case Report
  18. Orthotic Correction of Postural Unleveling in a Patient With Ankylosing Spondylitis
  19. Osteopathic Manipulative Treatment in the Management of Biliary Dyskinesia
  20. Clinical Images
  21. Orbital Myositis
  22. In Your Words
  23. My Mommy Is a Surgeon
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