Presumed isolated inflammation of the superior oblique muscle in idiopathic orbital myositis.
OBJECTIVE: To describe isolated involvement of the superior oblique muscle in association with idiopathic orbital myositis. DESIGN: A case report with review of the literature. PARTICIPANT: A 57-year-old man with acquired strabismus participated. INTERVENTION: Oral steroid therapy was administered. MAIN OUTCOME MEASURES: Clinical and radiographic features before and after treatment were measured. RESULTS: Computed tomographic scanning showed isolated enlargement of the superior oblique muscle consistent with orbital myositis. Clinical and radiographic abnormalities quickly improved after oral steroid therapy. CONCLUSIONS: Orbital pseudotumor may present as a myositis isolated to the superior oblique muscle. This extremely rare condition has been reported in only three patients, each of whom lacked early diagnosis or treatment. Early recognition may improve chances for a successful clinical outcome.