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Pediatric trochleitis associated with paranasal sinusitis: a case report

Hyunkyu Hong1, In Jeong Lyu2

  • 1Department of Ophthalmology, Nowon Eulji Medical Center, Eulji University School of Medicine, #68 Hangeulbiseok-ro, Nowon-gu, Seoul, Republic of Korea, 01830.

BMC Ophthalmology
|January 16, 2019
PubMed

Insights

Trochleitis, or trochlear pain, can be linked to sinusitis in children. Prompt sinusitis treatment resolved a child's periorbital pain and trochlear inflammation, highlighting this important association.

Area of Science:

  • Ophthalmology
  • Pediatric Otolaryngology
  • Pediatric Radiology

Background:

  • Trochleitis is defined as trochlear pain with radiologic evidence of inflammation.
  • The cause of trochleitis is typically idiopathic, with secondary causes being uncommon.
  • Trochleitis associated with paranasal sinusitis in pediatric patients has not been previously documented.

Observation:

  • An 8-year-old boy experienced left periorbital pain, localized tenderness over the trochlear region, and normal visual acuity/eye movements.
  • Orbital MRI revealed left trochlear focal enhancement and ipsilateral paranasal sinusitis.
  • Symptoms resolved completely with empirical sinusitis treatment, negating the need for local steroid injection.

Findings:

  • The case demonstrates a potential link between paranasal sinusitis and pediatric trochleitis.
  • Successful treatment of sinusitis led to the resolution of trochlear inflammation and pain.
  • This suggests sinusitis as a treatable secondary cause of trochleitis in children.

Implications:

  • Pediatricians and ophthalmologists should consider paranasal sinusitis in the differential diagnosis of pediatric trochleitis.
  • Early diagnosis and treatment of sinusitis may prevent the need for more invasive treatments for trochleitis.
  • This finding expands the understanding of secondary causes of trochleitis in the pediatric population.
Abstract

Keywords:
ChildrenSinusitisTrochlear painTrochleitis

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