32 year-old with proptosis




           
CT noncontrast axial                                                                                               


      
CT noncontrast coronal  




Findings:

Diffuse enlargement of the ocular muscles
Sparing of the musculotendinous junction
Proptosis

DDX:

Inflammatory pseudotumor
Lymphoma
Sarcoid
Amyloid
Graves Disease




Diagnosis:

Thyroid Orbitopathy (Grave’s Disease)


Discussion:

Exopthalmos with bilateral enlargement of EOM
Increased intra-ocular fat
“I’M SLOW” – Inferior>medial>superior>lateral>oblique
Predilection for muscle bellies; spares tendons
Lymphocyte inflammatory process




Submitted by Sung Logerfo, MD, UW Neuroradiology

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