What is the best radiographic study to evaluate orbital floor disruption?

The best radiographic study to evaluate orbital floor disruption is CT imaging. This method provides superior detail of the bony anatomy and any associated soft tissue injuries, which are crucial for assessing orbital fractures. CT scans allow for the visualization of complex structures in three dimensions, making it easier to identify fractures of the orbital floor, detect any entrapped muscles or fat, and assess for potential complications like ocular involvement.

In contrast, MRI is not typically the first choice for evaluating fractures since it is more suited for soft tissue assessment rather than bony injuries, and it can take longer to perform. X-rays can provide some information regarding orbital integrity but often lack the sensitivity and specificity needed to evaluate subtle fractures—especially those involving the orbital floor. Ultrasound is generally less effective for evaluating bony injuries and is more appropriate for soft tissue or fluid-related concerns; it is not commonly used for assessing fractured anatomy in the orbit. Thus, CT remains the most effective and widely accepted imaging modality for this specific issue.