Orbital x-ray

Orbital X-ray

An orbital X-ray in Waters view, showing the frontal sinuses and orbits.

An orbital X-ray is a diagnostic imaging technique used to visualize the orbits of the eyes, the frontal sinuses, and surrounding structures. This type of X-ray is particularly useful in assessing orbital fractures, foreign bodies, and other pathologies affecting the orbital region.

Indications

Orbital X-rays are typically indicated in the following scenarios:

• Suspected orbital fracture due to trauma.
• Detection of foreign bodies in the orbital region.
• Evaluation of sinusitis affecting the frontal sinuses.
• Assessment of tumors or cysts in the orbital area.

Technique

The procedure for obtaining an orbital X-ray involves positioning the patient in a specific manner to obtain clear images of the orbits and surrounding structures. The most common views used are:

• Waters view: The patient is positioned with the chin elevated and the nose and chin touching the X-ray plate. This view is particularly useful for visualizing the maxillary sinuses and the orbital floor.

• Caldwell view: The patient is positioned with the forehead and nose touching the X-ray plate. This view is used to assess the frontal sinuses and the superior orbital rim.

Interpretation

Close-up of the orbital region in Waters view.

Interpreting an orbital X-ray requires a thorough understanding of the normal anatomy of the orbits and surrounding structures. Key features to assess include:

• Orbital margins: Check for any discontinuities or irregularities that may indicate a fracture.
• Sinus opacification: Look for any signs of fluid levels or opacification in the sinuses, which may suggest sinusitis or other pathology.
• Foreign bodies: Identify any radiopaque foreign bodies that may be present within the orbital region.

Limitations

While orbital X-rays can provide valuable information, they have limitations. They may not detect non-radiopaque foreign bodies or subtle fractures. In such cases, CT scans or MRI may be more appropriate for detailed evaluation.

Related pages

• Orbit (anatomy)
• Frontal sinus
• Orbital fracture
• Sinusitis
• Computed tomography (CT)