Neuroimaging: orbital floor blow-out fracture: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: orbital floor blow-out fracture

Sample item

A cricket ball strikes a batsman's eye. He has diplopia on upgaze and enophthalmos, and a Waters view shows a soft tissue mass hanging from the orbital floor into the maxillary sinus. What is this finding?

ATeardrop sign of an orbital floor blow-out fractureBNaso-orbito-ethmoidal fractureCLe Fort I fractureDTripod fracture of the zygoma

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Teardrop sign of an orbital floor blow-out fracture

Increased orbital pressure fractures the thin orbital floor, and herniated orbital fat and inferior rectus hang into the maxillary sinus as a teardrop, causing restricted upgaze and diplopia. CT delineates the defect. A tripod fracture involves the zygoma and its three articulations.

Option by option

A. Teardrop sign of an orbital floor blow-out fracture (correct)
Correct. A teardrop of soft tissue at the orbital floor indicates a blow-out fracture.
B. Naso-orbito-ethmoidal fracture
A naso-orbito-ethmoidal fracture involves the nasal bones and medial orbital wall.
C. Le Fort I fracture
A Le Fort I fracture is a horizontal fracture above the maxillary teeth.
D. Tripod fracture of the zygoma
A tripod fracture separates the zygoma at its frontal, temporal and maxillary attachments.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Teardrop sign of an orbital floor blow-out fracture. Increased orbital pressure fractures the thin orbital floor, and herniated orbital fat and inferior rectus hang into the maxillary sinus as a teardrop, causing restricted upgaze and diplopia.

Why is "Naso-orbito-ethmoidal fracture" not the answer?

A naso-orbito-ethmoidal fracture involves the nasal bones and medial orbital wall.

Why is "Le Fort I fracture" not the answer?

A Le Fort I fracture is a horizontal fracture above the maxillary teeth.

Why is "Tripod fracture of the zygoma" not the answer?

A tripod fracture separates the zygoma at its frontal, temporal and maxillary attachments.

What concept does this question test?

It tests Neuroimaging: orbital floor blow-out fracture in Radiology. CT delineates the defect. A tripod fracture involves the zygoma and its three articulations.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: orbital floor blow-out fracture?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.