1. MedPix Medical Image Database COW - Case of the Week Case Contributor: Joshua S Ritenour Affiliation: Uniformed Services University

2. MedPix No: 3811 - History Pt Demographics: Age = 15 y.o. Gender = boy 15 y/o WM 18 hrs s/p *getting kneed* in right eye during football game. Pt c/o right-sided HA, aggravated with light and visual stimuli. No c/o f/c/n/v or diplopia Downloaded by (-1)

3. MedPix No: 3811 - EXAM & LABS OD exam- unable/unwilling to cooperate with visual acuity, CVF, or retinal examination. Paralysis/limitation of upward and downward gaze. OS exam and remainder of physical exam unremarkable.

4. Orbit Blowout Fracture Orbital fx with inferior rectus above, below and trapped within the orbital floor. Note hematoma in maxillary sinus Downloaded by (-1)

5. Orbit Blowout Fracture Orbital fx with inferior rectus above, below and trapped within the orbital floor. Note hematoma in maxillary sinus Downloaded by (-1)

6. Orbit Blowout Fracture Orbital fx with inferior rectus above, below and trapped within the orbital floor. Note hematoma in maxillary sinus Downloaded by (-1)

7. Orbit Blowout Fracture Orbital fx with inferior rectus above, below and trapped within the orbital floor. Note hematoma in maxillary sinus Downloaded by (-1)

8. Orbit Blowout Fracture Orbital fx with inferior rectus above, below and trapped within the orbital floor. Note hematoma in maxillary sinus Downloaded by (-1)

9. FINDINGS Frontal and lateral skull films unremarkable. No sinus (Waters* view) performed. Orbital fx with inferior rectus above, below and trapped within the orbital floor. Note hematoma in maxillary sinus

10. DIFFERENTIAL DIAGNOSIS What is your Differential Diagnosis? Orbital floor fracture

11. Diagnosis: Orbit Blowout Fracture Dx Confirmed by: Clinical and Imaging

12. DISCUSSION