The following facial x-ray (OM view) is from a 25 year old who has been punched in the face and has presented with pain, swelling and bruising around the left eye. What can be seen?
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The OM (occipitomental) view shows left orbital emphysema, also called ‘the black eyebrow sign’. The medial aspect of the left orbital roof appears irregular.
CT of the facial bones showed a depressed fracture of the superomedial aspect of the left orbital roof communicating with the left frontal sinus, causing left orbital emphysema.
The patient was referred to a maxillofacial surgeon and underwent surgery.
Facial x-rays can be difficult to interpret. To make the interpretation a little bit easier, the affected side should be compared to the normal side. Also, tracing the McGrigor’s lines help. Details on the McGrigor’s line scan be found here.
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