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nbme23/Block 4/Question#44 (reveal difficulty score)
A 44-year-old man is brought to the emergency ...
Entrapment of the inferior rectus muscle🔍,📺

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submitted by thomasalterman(163),
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taiePnt ash a caftrure ot het frneiiro .obitr Tish cna mgd V2 or aentpr hte IR Onyl RI eptranentm oluwd mipari osnivi.

nlkrueger  if this isn't a globe rupture than idk what is tbh +16  
mousie  the air in the center of the globe made me think rupture too ..... +4  
sajaqua1  There may be some global rupture, but impairment of one of the ocular muscles causing diplopia would still be the best explanation for this patient's double vision. +13  
catch-22  Globe rupture leads to entrapment of the IR muscle which causes diplopia. The question is asking what is causing his visual complaints, which is diplopia, not loss of vision. +3  

UW QID# 11742 had the same question. Fracture of the orbital floor causes displacement of the orbital contents through the floor and can cause enophthalmos and entrapment of the IR muscle (diplopia when looking up). Also, damage to the infraorbital nerve (a branch of V2), which exits through the infraorbital foramen, will cause numbness of the upper cheek, upper lip, and upper gingiva.

+/- fatboyslim(64),

submitted by diabetes(29),
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tiblaor folro uerrtcaf edal ot enatnrepmt fo IMR eldaing to odlpewi,api can ese ari in eht ortib lsup pmealdtensci of eye siuest and eth ulcesm in iarmyaxll sisnu .

submitted by adong(107),
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tyckir eiamg utb squinteo si giskan moer piefcllsciay butao sih usliva lcnmiptaso hchwi is jtsu lbdo"eu isvo"in os IR mtreetnpna si eth tbse wsanre

submitted by charcot_bouchard(488),
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ihsT titpnae ash a blritoa otbolwu ef.urtacr ees eth reat pord sn.ig