Trauma to the Face: Diagnosis and Symptoms
What is the most likely diagnosis for a 16-year-old male hit by a line drive baseball on the left side of his face?
A Zygomatic arch fracture
B Orbital blowout fracture
C Le Fort I fracture
D Le Fort II fracture
E Le Fort III fracture
What symptoms support the diagnosis of an orbital blowout fracture?
Answer:
The most likely diagnosis is B. Orbital blowout fracture.
Symptoms:
Enophthalmos, reduced sensation in the cheek, diplopia during eye movement testing, air-fluid level in the maxillary sinus, and a fractured orbit indicate an orbital blowout fracture.
A 16-year-old male who was struck by a line drive baseball on the left side of his face is likely to have an orbital blowout fracture. This diagnosis is supported by various symptoms that manifest after the injury.
Enophthalmos, which refers to the recession of the eyeball into the orbit, can occur due to the force of impact pushing the walls of the orbit inward. The reduced sensation in the cheek is a result of nerve damage caused by the fracture, leading to numbness in that area.
Diplopia, or double vision, during extraocular motion testing is a common symptom of an orbital blowout fracture. This occurs due to the disruption in eye movement coordination caused by the fracture.
The presence of an air-fluid level in the left maxillary sinus seen in the x-ray indicates a communication between the sinus and the orbit, suggesting a fracture in that region. The fractured orbit further confirms the diagnosis of an orbital blowout fracture.
Overall, based on the details provided about the injury and the symptoms exhibited by the patient, the most likely diagnosis for the 16-year-old male is an orbital blowout fracture.