Medial rectus muscle cysticercosis: an assessment using ultrasonography and CT.

To cite: Pujari A, Behera AK. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2016217953 DESCRIPTION A 9-year-old boy presented with the history of progressive pain, watering and abduction limitation for 1-week duration. Medical history revealed two episodes of recurrent congestion on the nasal side and watering 2 and 4 week’s prior. On examination visual acuity was 20/200 improving to 20/40 with refraction and 20/20 in right and left eye, respectively; extraocular motility was severely restricted in abduction and elevation with minimal restriction in depression and adduction (figure 1). Fundus examination showed localised choroidal mount on the nasal retina without any intraocular cyst. Ultrasonography of the orbit revealed a large cyst in the medial rectus muscle with peripheral high amplitude spike echo (figure 2A). Subsequent CT imaging of the head and neck showed a well-defined large cyst in medial rectus indenting the globe with a peripheral high amplitude dot, without any intracranial foci (figure 2B). Both the ultrasonography and CT features suggested myocysticercosis with peripheral scolex.