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Clinical Problem Solving: Radiology
December 2002

Radiology Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2002;128(12):1428. doi:

A 24-YEAR-OLD MAN presented with a 6-month history of right-sided nasal congestion and maxillary pain with intermittent facial swelling, which was associated with a dull ache in the upper premolar and molar teeth on the right side. The facial swelling and pain increased during episodes of sneezing and airplane flights. There was no history of occupational or recreational barotrauma. Examination showed mild right-sided facial swelling and exophthalmos of the right eye. Extraocular eye movements, visual acuity, and visual fields were normal. Nasendoscopy showed an inflamed edematous middle turbinate, with a narrow middle meatus. An urgent computed tomographic scan of the paranasal sinuses was performed. Representative coronal images are shown in Figure 1, Figure 2, and Figure 3 and axial images in Figure 4 and Figure 5.