Difference between revisions of "Thyroid eye disease"

From Radipedia
Jump to: navigation, search
(Differential)
 
Line 22: Line 22:
 
== Differential ==
 
== Differential ==
 
*[[Lymphoma]]
 
*[[Lymphoma]]
*Orbital pseudotumor - idiopathic '''painful''' inflammation
+
*Orbital pseudotumor - idiopathic '''painful''' inflammation, "dirty fat"
 
*[[Sarcoidosis]]
 
*[[Sarcoidosis]]
 
*Tolosa Hunt syndrome - painful opthalmoplegia caused by cavernous sinus inflammation (likely continuum of orbital pseudotumor)
 
*Tolosa Hunt syndrome - painful opthalmoplegia caused by cavernous sinus inflammation (likely continuum of orbital pseudotumor)

Latest revision as of 18:19, 28 April 2011

(aka Grave's Ophthalmoplegia, Hyperthyroidsim Related Infiltrative Ophthalmoplegia, Thyroid Associated Orbitopathy)


Enlargement of the extraocular muscles caused by T-lymphocyte infiltration, adipose hypertrophy, scarring and irreversible proptosis.


Order of Extraocular Muscle Involvement (I'M SLO)

  • Inferior rectus
  • Medial rectus
  • Superior rectus
  • Lateral rectus - if isolated lateral rectus think orbital pseudotumor
  • Obliques


  • Bilateral and symetric involvement is typical
  • Tendon is typically spared (unlike orbital pseudotumor)
  • Can be exacerbated by radioiodine therapy (prednisone can prevent flare)
  • Eye complications occur in 25-50% of Grave's
  • Painless


Differential

  • Lymphoma
  • Orbital pseudotumor - idiopathic painful inflammation, "dirty fat"
  • Sarcoidosis
  • Tolosa Hunt syndrome - painful opthalmoplegia caused by cavernous sinus inflammation (likely continuum of orbital pseudotumor)