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Delbello F, Spinnato P, Aparisi Gomez MP. Calcific Tendinopathy Atypically Located Outside the Rotator Cuff: A Systematic Review. Curr Med Imaging 2024; 20:e100423215585. [PMID: 37038296 DOI: 10.2174/1573405620666230410091749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/24/2023] [Accepted: 02/20/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND AND PURPOSE Calcific tendinopathy is a common cause of painful shoulder easily identified with ultrasound or conventional radiography. Although the rotator cuff is by far the most common location of the disease and diagnostic or treatment strategies are well known in clinical practice, a lack of awareness characterizes the assessment of the other sites affected by this condition; consequently, the risk of underestimating the prevalence of atypical non-rotator cuff calcific tendinopathy is high. This may lead to expensive or invasive diagnostic exams and/or inappropriate treatment, whereas the condition is usually self-limited. The present study aims at analysing the frequency of calcific tendinitis in uncommon sites, in order to fill a gap in knowledge and awareness regarding non-rotator cuff calcific tendinopathy, thus avoiding improper clinical choices and helping to identify this condition. METHODS This systematic review was conducted following the PRISMA guidelines. We performed a search on Pubmed and Scopus databases concerning atypically sited extra-rotator cuff calcific tendinopathy published since 1950. RESULTS The research found a total of 267 articles and 793 non-rotator cuff cases of calcific tendinopathy registered. The spine (213 – 26.86%), foot and ankle (191 – 23.95%), and hip (175 – 22.06%) appeared to be the most common sites of calcific tendinopathy after the rotator cuff, whereas the longus colli C1-C2 (204 – 25.72%), Achilles (173 – 21.81%), and rectus femori (61 – 7.69%) were the most commonly affected tendons. CONCLUSION A better awareness of this condition in several different sites of the body than the rotator cuff could avoid unnecessary choices both in assessment and treatment.
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Affiliation(s)
- Federica Delbello
- Department of Rehabilitation Medicine, Gervasutta Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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Filipovic T, Avsenik J. Retropharyngeal calcific tendinitis in the neurological emergency unit, report of three cases and review of the literature. Radiol Oncol 2023; 57:430-435. [PMID: 38038426 PMCID: PMC10690742 DOI: 10.2478/raon-2023-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/17/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Retropharyngeal calcific tendinitis (RCT) is a relatively benign condition of calcination of the longus colli muscle tendon of unknown origin, which causes severe acute neck pain. However, it is often not recognised, which leads to delayed diagnosis and unnecessary treatment. PATIENTS AND METHODS We have searched PubMed and Google Scholar for publications which reported at least one patient with RCT and were published in the last 20 years. The literature was then analysed according to the PRISMA-S protocol. We also report three patients with RCT presenting at the Neurological Emergency Unit, University Medical Centre, Ljubljana, Slovenia, from 1 January 2020 to 1 June 2022. We discuss their clinical presentation and differential diagnosis, explain our decision-making process, and briefly describe the clinical course. Case reports have been performed according to the CARE protocol. RESULTS We have analysed a total of 112 titles with 231 patients. The most frequent symptoms and signs were: neck pain, neck stiffness and odynophagia, as was the case in our reported cases. CONCLUSIONS RCT is a dramatic yet self-limiting condition, often not recognised in time. An effort should be made to increase neurologists' awareness about this condition.
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Affiliation(s)
- Tatjana Filipovic
- Institute of Clinical Neurophysiology, Division of Neurology, University Medical Centre, Ljubljana, Slovenia
| | - Jernej Avsenik
- Institute of Radiology, University Medical Centre, Ljubljana, Slovenia
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Karatağ G, Nusran G, Zateri C, Karatağ O. The critical role of computed tomography in the differential diagnosis of acute calcific tendinitis of longus colli muscle: A case report. Turk J Phys Med Rehabil 2023; 69:549-552. [PMID: 38766587 PMCID: PMC11099850 DOI: 10.5606/tftrd.2023.10476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/10/2022] [Indexed: 05/22/2024] Open
Abstract
Acute longus colli calcific tendinitis (ALCT) is a non-infectious inflammatory process. The typical clinical triad is acute neck pain, neck stiffness, and odynophagia. These findings can be confused with many common pathologies. As ALCT treatment is conservative and relatively easy, making the correct diagnosis is important. Radiology is of critical importance in the diagnosis of ACLT. The detection of prevertebral calcification by computed tomography is pathognomonic. Herein, we present a case with a sudden onset of neck and occipital pain accompanied by odynophagia following acute trauma and diagnosed with ALCT by radiological examination.
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Affiliation(s)
- Gülden Karatağ
- Department of Radiology, Çanakkale State Hospital, Çanakkale, Türkiye
| | - Gürdal Nusran
- Department of Orthopaedics and Traumatology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Türkiye
| | - Coşkun Zateri
- Department of Radiology, Physical Medicine and Rehabilitation, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Türkiye
| | - Ozan Karatağ
- Department of Radiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Türkiye
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Wolf J, Niggemann P, Schaefer N, Tollens N, Rittmann M, Martins Dos Santos M, Tews B. [Retropharyngeal calcific tendinitis-An underestimated cause of acute neck pain]. Schmerz 2023:10.1007/s00482-023-00735-4. [PMID: 37405523 DOI: 10.1007/s00482-023-00735-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Retropharyngeal calcific tendinitis is an aseptic inflammation of the longus cervicis muscle. This rare acute pain disorder of the neck region is a prognostically benign condition compared to neurological or otorhinolaryngological differential diagnoses. OBJECTIVE To capture the clinical appearance, diagnostics, treatment and course of this rare disease. MATERIAL AND METHODS In this retrospective monocentric observational study, demographic, clinical, paraclinical as well as treatment and follow-up data of all inpatients with a diagnosis of retropharyngeal calcific tendinitis admitted to the Diako Hospital Mannheim in the years 2018 to 2021 were analyzed. RESULTS This study included four female and one male patient with an age between 36 years and 77 years. Severe neck pain with restriction of cervical spine rotation was the leading clinical appearance, in four out of five patients there was a painful swallowing disorder. Inflammatory markers were elevated in four patients. Characteristic MRI or CT imaging alterations of the cervical spine confirmed the diagnosis. The symptoms resolved within 4-14 days after treatment with nonsteroidal anti-inflammatory drugs (NSAID) and four patients additionally received glucocorticoids. No recurrences were observed during the follow-up period of 5-30 months. CONCLUSION The good prognosis of this rare disease is reflected by the rapid remission of symptoms under NSAIDs and glucocorticoids and by the absence of recurrences during follow-up. CT or MRI imaging is required to rule out differential diagnoses, and to confirm the characteristic imaging alterations of retropharyngeal calcific tendinitis. Additionally, cerebrospinal fluid puncture and otorhinolaryngological assessment may be necessary in some cases.
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Affiliation(s)
- Joachim Wolf
- Klinik für Neurologie, Diako Mannheim, Speyerer Str. 91-93, 68163, Mannheim, Deutschland.
| | | | | | - Nadine Tollens
- Klinik für Neurologie, Diako Mannheim, Speyerer Str. 91-93, 68163, Mannheim, Deutschland
| | - Michael Rittmann
- Klinik für Neurologie, Diako Mannheim, Speyerer Str. 91-93, 68163, Mannheim, Deutschland
| | | | - Britta Tews
- Klinik für Neurologie, Diako Mannheim, Speyerer Str. 91-93, 68163, Mannheim, Deutschland
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Hirvonen J, Heikkinen J, Nyman M, Happonen T, Velhonoja J, Irjala H, Soukka T, Mattila K, Nurminen J. MRI of acute neck infections: evidence summary and pictorial review. Insights Imaging 2023; 14:5. [PMID: 36617619 PMCID: PMC9826778 DOI: 10.1186/s13244-022-01347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/04/2022] [Indexed: 01/09/2023] Open
Abstract
Infection of the deep neck spaces is a life-threatening acute illness that requires prompt diagnosis and treatment. Magnetic resonance imaging (MRI) offers unsurpassed soft tissue discrimination and is therefore well suited for imaging neck infections. Recently, the feasibility, diagnostic accuracy, and clinical significance of this method have been documented in patients with acute neck infections. This review article summarizes the scientific evidence, provides a practical guide to image acquisition and interpretation, reviews the most common imaging findings, and discusses some difficult diagnoses and pitfalls in acute neck infections, to help both radiologists and clinicians in managing these critically ill patients.
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Affiliation(s)
- Jussi Hirvonen
- grid.1374.10000 0001 2097 1371Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland ,grid.412330.70000 0004 0628 2985Medical Imaging Center, Department of Radiology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Jaakko Heikkinen
- grid.1374.10000 0001 2097 1371Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Mikko Nyman
- grid.1374.10000 0001 2097 1371Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Tatu Happonen
- grid.1374.10000 0001 2097 1371Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jarno Velhonoja
- grid.1374.10000 0001 2097 1371Department of Otorhinolaryngology-Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | - Heikki Irjala
- grid.1374.10000 0001 2097 1371Department of Otorhinolaryngology-Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | - Tero Soukka
- grid.1374.10000 0001 2097 1371Department of Oral and Maxillofacial Surgery, University of Turku, Turku, Finland
| | - Kimmo Mattila
- grid.1374.10000 0001 2097 1371Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Janne Nurminen
- grid.1374.10000 0001 2097 1371Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
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[Retropharyngeal tendinitis : Rare differential diagnosis of acute neck pain]. Unfallchirurg 2022; 125:909-914. [PMID: 35024872 PMCID: PMC8756746 DOI: 10.1007/s00113-021-01138-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 11/10/2022]
Abstract
Atraumatische Nackenschmerzen sind ein häufiger Vorstellungsgrund für Patienten in der Notaufnahme. Für die behandelnden Ärzte ist dabei der Ausschluss möglicherweise lebensbedrohlicher Erkrankungen, wie Spondylodiszitis, retropharyngealer Abszess oder Meningitis, oft eine große Herausforderung. In dieser Kasuistik wird der seltene Fall der retropharyngealen Tendinitis vorgestellt, einer wenig bekannten und dadurch sicherlich unterdiagnostizierten Entität. Sie ist charakterisiert durch einen stark reduzierten Bewegungsumfang der HWS, erhöhte Infektparameter und einen pathognomonischen MRT-Befund. Zusätzlich zur Fallpräsentation soll im Rahmen eines kurzen Reviews die Charakteristik der retropharyngealen Tendinitis noch genauer dargestellt werden. So ist es das Ziel dieser Arbeit, die behandelnden Ärzte für dieses Krankheitsbild zu sensibilisieren, um in Zukunft falsche bzw. unnötige Therapien zu vermeiden.
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Ho ML. Pediatric Neck Masses: Imaging Guidelines and Recommendations. Radiol Clin North Am 2021; 60:1-14. [PMID: 34836558 DOI: 10.1016/j.rcl.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Neck masses commonly present in children and several potential diagnostic and management pathways exist, though with a paucity of evidence-based recommendations. The purpose of this article is to evaluate the current literature and utilization of various diagnostic imaging modalities , with a review of imaging features and management pearls for pediatric neck masses. A comprehensive understanding and practical imaging workflow will guide optimal patient workup and management.
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Affiliation(s)
- Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
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Nakanishi Y, Tanaka H, Toyoshima H, Sakabe S. Woman with neck pain and odynophagia. J Am Coll Emerg Physicians Open 2021; 2:e12466. [PMID: 34667974 PMCID: PMC8504804 DOI: 10.1002/emp2.12466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yuki Nakanishi
- Department of Infectious DiseasesJapanese Red Cross Ise HospitalIseMieJapan
| | - Hiroyuki Tanaka
- Department of Infectious DiseasesJapanese Red Cross Ise HospitalIseMieJapan
| | - Hirokazu Toyoshima
- Department of Infectious DiseasesJapanese Red Cross Ise HospitalIseMieJapan
| | - Shigetoshi Sakabe
- Department of Infectious DiseasesJapanese Red Cross Ise HospitalIseMieJapan
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Upper Neck Spaces: Anatomy and Pathology. Clin Neuroradiol 2021. [DOI: 10.1007/978-3-319-61423-6_89-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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