Imaging of the orbits, paranasal sinuses and brain ( ideally with contrast ) is a very important radiological emergency in selected patients, typically children, with orbital cellulitis.

The scan has three chief purposes:

1.  Is there a subperiosteal collection?

2.  It there any intracranial extension?

3.  Is there underlying severe sinusitis?

This case shows the typical 'positive' scan - a subperiosteal collection, which warrants prompt treatment to prevent any threat to vision.

Emergency fiber optic endoscopic surgery was performed - pus drained from the maxillary and ethmoidal sinuses.