Answers :
What can you see?
There is a fracture of the inferior orbital margin. This is an 'impure' orbital blowout fracture - a 'pure' or isolated blow out fracture does not involve the strong bones of the orbital rim and is often difficult to see on plain radiographs.
Orbital emphysema is seen on the right - the 'black eyebrow' sign. This represents air that has entered the orbit from a sinus.
There is also an air-fluid level in the right maxillary sinus.
What clincial features would you expect the patient to exhibit on examination ?
In addition to signs of trauma, on examination the patient may have diplopia on upward gaze due to herniation and entrapment of the inferior rectus muscle through a defect in the floor of the orbit.
What further radiological test is often performed in these cases ?
A CT scan of the face with 3D reconstructions is often performed in facial trauma to establish the exact position and extent of the fractures.
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