Findings:
Compared to the previous study, newly appreciated, diffuse thickening of the left medial rectus muscle involving its belly and tendineous insertion, reaching maximal thickness of about 10mm. Mild inflammatory changes of the adjacent orbital fat. It shows an iso-signal to the normal extraocular muscles on T1, high signal on T2 with relatively homogeneous enhancement on postcontrast sequences.
Also, there is mild thickening and high T2 signal involving the left inferior oblique and lateral rectus muscle, which is regressive when compared to the previous study.
Interval resolution of the previously seen thickening and signal changes of the right lateral rectus muscle. Currently normal appearance of the right orbit.
Mild background small vessel ischaemic disease. The brain parenchyma is otherwise unremarkable. No abnormal signal on the susceptibility-weighted images or diffusion/ADC images is identified. No pathological intracranial enhancement. The intracranial circulation is unremarkable.
Partially empty sella is noted.
The paranasal sinuses and mastoid air cells are clear.
No bony abnormality is seen. The craniocervical junction is normal.
Conclusion:
Features suggestive of a myositic orbital pseudotumor involving the left medial rectus muscle.
Mild, possibly residual inflammatory changes of the left inferior oblique and left lateral rectus muscle.
Interval resolution of the previously described myositis of the right lateral rectus muscle.