Abdallah Abdallah Said, Fadil Mohamed, El Haddad Siham, Allali Nazik, Chat Latifa
Department of Radiology, Children's Hospital of Rabat, Ibn Sina University Hospital Center, Mohammed V University, Rabat, MAR.
Cureus. 2025 Aug 13;17(8):e89963. doi: 10.7759/cureus.89963. eCollection 2025 Aug.
Bilateral proptosis in a child presents a significant diagnostic dilemma, requiring a systematic radiological evaluation to differentiate between a spectrum of etiologies, from inflammatory conditions to malignancy. This challenge is amplified when associated with systemic autoimmune diseases, such as juvenile idiopathic arthritis (JIA). We report the case of a 12-year-old female patient with JIA who presented with bilateral proptosis ultimately diagnosed as idiopathic orbital inflammatory disease (IOID). This report describes the key imaging findings that led to the diagnosis, discusses the rarity of this clinical association, and emphasizes the pivotal role of a systematic radiological evaluation. Computed tomography (CT) and magnetic resonance imaging (MRI) were essential in characterizing the bilateral intraconal infiltrates, with the absence of bone destruction and specific signal characteristics helping to exclude key differential diagnoses. This case demonstrates that a rigorous radiological evaluation is essential for distinguishing pediatric IOID from its serious mimics and guiding appropriate patient management.
儿童双侧眼球突出带来了重大的诊断难题，需要进行系统的影像学评估，以区分从炎症性疾病到恶性肿瘤等一系列病因。当与系统性自身免疫性疾病，如幼年特发性关节炎（JIA）相关时，这一挑战会更加严峻。我们报告了一例12岁患JIA的女性患者，该患者出现双侧眼球突出，最终被诊断为特发性眼眶炎性疾病（IOID）。本报告描述了导致该诊断的关键影像学表现，讨论了这种临床关联的罕见性，并强调了系统影像学评估的关键作用。计算机断层扫描（CT）和磁共振成像（MRI）对于明确双侧肌锥内浸润至关重要，无骨质破坏及特定的信号特征有助于排除主要的鉴别诊断。该病例表明，严格的影像学评估对于区分儿童IOID与其严重的模仿疾病以及指导适当的患者管理至关重要。
