Q:

A 14 year old boy fell and hit his head in the playground school. He didn’t lose consciousness. He has swelling and tenderness of the right cheek with a subconjuctival hemorrhage on his right eye. What is the most appropriate initial investigation?

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A 14 year old boy fell and hit his head in the playground school. He didn’t lose consciousness. He has swelling and tenderness of the right cheek with a subconjuctival hemorrhage on his right eye. What is the most appropriate initial investigation?


  1. CT brain
  2. EEG
  3. MRI
  4. Skull XR
  5. Facial XR

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The key is E. Facial X-ray. [There is no sign of basal fracture (Panda sign is suggestive of basal fracture, not subconjunctival hemorrhage- unless posterior border of hemorrhage is not visible) and no indication of CT scan (there are some criteria for CT scan which are not fulfilled here)].

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