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World J Radiol. Apr 28, 2014; 6(4): 106-115
Published online Apr 28, 2014. doi: 10.4329/wjr.v6.i4.106
Orbital inflammatory disease: Pictorial review and differential diagnosis
Michael N Pakdaman, Ali R Sepahdari, Sahar M Elkhamary
Michael N Pakdaman, Ali R Sepahdari, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
Sahar M Elkhamary, Radiology Department, King Khaled Eye Specialist Hospital, Saudi Arabia and Diagnostic Radiology Department, Mansoura Faculty of Medicine, Riyadh 12329, Egypt
Author contributions: Pakdaman MN, Sepahdari AR and Elkhamary SM contributed equally to this work; Sepahdari AR designed the review article structure; Pakdaman MN and Sepahdari AR performed literature review and write-up of this review manuscript; Elkhamary SM analyzed the clinical relevance and relevance of supporting articles, and contributed to drafting and revision of the manuscript; Sepahdari AR provided final approval of the version to be published.
Correspondence to: Ali R Sepahdari, MD, Assistant Professor, Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 757 Westwood Plaza, Suite 1621D, Los Angeles, CA 90095, United States.
Telephone: +1-310-2676708 Fax: +1-310-2673635
Received: December 16, 2013
Revised: January 21, 2014
Accepted: April 11, 2014
Published online: April 28, 2014

Orbital inflammatory disease (OID) represents a collection of inflammatory conditions affecting the orbit. OID is a diagnosis of exclusion, with the differential diagnosis including infection, systemic inflammatory conditions, and neoplasms, among other conditions. Inflammatory conditions in OID include dacryoadenitis, myositis, cellulitis, optic perineuritis, periscleritis, orbital apicitis, and a focal mass. Sclerosing orbital inflammation is a rare condition with a chronic, indolent course involving dense fibrosis and lymphocytic infiltrate. Previously thought to be along the spectrum of OID, it is now considered a distinct pathologic entity. Imaging plays an important role in elucidating any underlying etiology behind orbital inflammation and is critical for ruling out other conditions prior to a definitive diagnosis of OID. In this review, we will explore the common sites of involvement by OID and discuss differential diagnosis by site and key imaging findings for each condition.

Keywords: Orbit, Inflammation, Pseudotumor, Orbital inflammatory disease, Nonspecific orbital inflammation, Dacryoadenitis, Myositis, Orbital cellulitis, Optic perineuritis, Orbital apicitis

Core tip: This review provides a pictorial summary of orbital inflammatory disease (OID). It outlines many key aspects of OID on imaging that can be used to distinguish from other pathologic conditions. The review also provides an up-to-date overview of the best approaches to imaging workup when suspecting OID.