Thyroid ophthalmopathy vs Orbital pseudo-tumor

Listed are the pathologies that closely resemble each other, and these pathologies are the favourite questions in final FRCR part A exam.

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		Orbits
	Thyroid ophthalmopathy		Orbital pseudotumor
1			Usually acute, unilateral, painful ophthalmoplegia
2	Sparing of tendinous insertion “Coke-bottle” sign		Involve tendinous insertion
3	EOM affected: Inf -> Med -> Sup -> Lat -> Obliq “I’M SLO”
4			Enhancement of fat
5			a/w Retroperitoneal fibrosis (10% a/w autoimmune disease) a/w Lacrimal gland enlargement
6	Intra-conal fat stranding
7	Commonest cause of uni(15%)/bilat(85%) Proptosis in adult		Commonest cause of intra-orbital mass in adults
8	Male > Female		Idiopathic inflammatory
			Acute type: More common, better prognosis, respond to steroid Chronic type: Frequently require Chemo & RadioRx

*EOM: Extra-Ocular Muscle
*Inf: Inferior rectus; Med: Medial rectus; Sup: Superior rectus; ;
Lat: Lateral rectus; Obliq: Superior oblique

Thyroid opthalmopathy: Sparing of tendinous portion, giving 'coke bottle' appearance

Thyroid opthalmopathy: Oedematous inferior and medial recti muscles