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Turner VL, Martinez C, Rocha J, Valenzuela A. Acute calcific tendinitis of the longus colli: A case report. Radiol Case Rep 2024; 19:2650-2653. [PMID: 38645950 PMCID: PMC11031716 DOI: 10.1016/j.radcr.2024.03.027] [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] [Received: 12/14/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/23/2024] Open
Abstract
Acute calcific longus colli tendinitis is a differential diagnosis of neck pain. Typical presentation consists in a triad of symptoms including acute onset neck pain, neck stiffness and odynophagia. Computed tomography (CT) is the gold standard for acute calcific longus colli tendinitis diagnosis and the main radiological findings include prevertebral soft tissue swelling and the presence of amorphous calcifications. The case involves a 39-year-old female who presented to the emergency department with acute unilateral cervical pain that resulted in acute calcific longus colli tendinitis.
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Affiliation(s)
| | - Camila Martinez
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Judith Rocha
- Department of Rheumatology and Clinical Immunology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Antonia Valenzuela
- Department of Rheumatology and Clinical Immunology, Pontificia Universidad Católica de Chile, Santiago, Chile
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2
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Takahashi H, Fujisaki M, Hata Y. An unexpected detour: Acute throat pain and trismus in a fast-food deliveryman. Eur J Intern Med 2024; 125:120-121. [PMID: 38604938 DOI: 10.1016/j.ejim.2024.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/29/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Hidenori Takahashi
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, Shinagawa-ku, Tokyo, Japan.
| | - Marino Fujisaki
- Department of Respiratory Medicine, Tokyo Shinagawa Hospital, Shinagawa-ku, Tokyo, Japan
| | - Yuko Hata
- Department of Otolaryngology, Tokyo Shinagawa Hospital, Shinagawa-ku, Tokyo, Japan
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3
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Mohyeldin M, Singh H, Shrestha M, Leitao M, Kumar J. Acute Calcific Tendinitis of the Longus Colli: A Case Report and Review of the Literature. Cureus 2024; 16:e60409. [PMID: 38883022 PMCID: PMC11179152 DOI: 10.7759/cureus.60409] [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] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
Acute calcific tendinitis of the longus colli (ACTLC) is a rare, self-resolving condition caused by calcium hydroxyapatite crystal deposition in the longus colli muscle tendons. We present a case of a 46-year-old female with a history of hypertension who presented with right-sided neck pain, worsening abdominal pain, nausea, bloody emesis, and generalized body aches in the context of recent alcohol use. Physical examination revealed neck pain with limited range of motion, induration, and tenderness in the right and posterior neck areas. Laboratory findings showed elevated white cell count, inflammatory markers, and metabolic acidosis with an elevated anion gap and lactic acid level. Computed tomography (CT) of the neck with contrast demonstrated amorphous calcification in the longus colli tendons and retropharyngeal effusion, consistent with the diagnosis of ACTLC. The patient was treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and supportive care, leading to symptom resolution. This case highlights the importance of considering ACTLC in the differential diagnosis of acute neck pain and the role of CT imaging in establishing the diagnosis. Prompt recognition and appropriate management of ACTLC can prevent unnecessary interventions and lead to improved patient outcomes.
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Affiliation(s)
| | | | | | | | - Jai Kumar
- Internal Medicine, BronxCare Health System, Bronx, USA
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4
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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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5
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Mizumoto J. Acute Calcific Tendinitis of the Longus Colli Muscle. Cureus 2023; 15:e50599. [PMID: 38222240 PMCID: PMC10788145 DOI: 10.7759/cureus.50599] [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] [Accepted: 12/15/2023] [Indexed: 01/16/2024] Open
Abstract
A man in his 40s complained of posterior neck pain and headache after a local festival. The patient also developed mild fever, odynophagia, and difficulty opening his mouth widely. Physical examination revealed mild rightward torticollis and limited ranges of neck motion. A neck computed tomography (CT) revealed calcification on the tendon of the lingus colli muscle. The pain decreased rapidly after acetaminophen and loxoprofen administration. Physicians should recognize the clinical characteristics of acute calcific tendinitis of the longus colli muscle (ACTLC) and conduct thorough follow-ups to exclude infection.
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Affiliation(s)
- Junki Mizumoto
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, University of Tokyo, Tokyo, JPN
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6
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Igami E, Fukae J, Kanazawa K, Fuse A, Nakajima A, Eguchi H, Hattori N, Shimo Y. Two rare diseases, acute calcific retropharyngeal tendinitis, and crowned dens syndrome, mimicking meningitis: A case report. Front Neurol 2022; 13:946222. [PMID: 36341107 PMCID: PMC9635314 DOI: 10.3389/fneur.2022.946222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/23/2022] [Indexed: 11/18/2022] Open
Abstract
We report two rare cases. One involved acute calcific retropharyngeal tendinitis, an inflammatory condition of the longus colli tendon triggered by the deposition of calcium hydroxyapatite crystals. The other involved crowned dens syndrome, caused by pseudogout of the atlantoaxial junction following deposition of calcium pyrophosphate dehydrate or calcium hydroxyapatite. Although these two diseases involve different mechanisms, the common symptoms of neck pain and fever resemble those of meningitis. Accurate diagnosis can thus be difficult without background knowledge of these conditions. Cerebrospinal fluid examination and cervical computed tomography are useful for distinguishing these pathologies from meningitis.
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Affiliation(s)
- Eriko Igami
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Jiro Fukae
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
- *Correspondence: Jiro Fukae
| | - Kazo Kanazawa
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Atsuhito Fuse
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Asuka Nakajima
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
- Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroto Eguchi
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
- Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo, Japan
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
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7
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Qureshi PAAA, Bollason G, Ágústsson KL. Acute Calcific Tendinitis of the Longus Colli Muscles: An Entity That Should Be Known by Emergency Radiologists. Cureus 2022; 14:e25518. [PMID: 35800797 PMCID: PMC9245335 DOI: 10.7759/cureus.25518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/09/2022] Open
Abstract
Acute calcific tendinitis of the longus colli muscle (LCM) also called acute calcific prevertebral tendinitis or retropharyngeal tendinitis is an inflammatory process of the LCM that results in acute and debilitating symptoms. Although the imaging appearances of this uncommon condition are specific, due to the rarity of this entity and lack of familiarity, it can be sometimes misdiagnosed as a retropharyngeal abscess. This case report presents characteristic radiological features of the acute calcific tendinitis of the LCM, which may be helpful for the emergency radiologist to accurately diagnose this condition to avoid unnecessary surgical interventions.
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8
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Hori H, Fukuchi T, Sugawara H. A case of acute longus colli tendinitis: an inflammatory disease that causes sudden neck pain and backward neck bending difficulty. Oxf Med Case Reports 2022; 2022:omac009. [PMID: 35198229 PMCID: PMC8858386 DOI: 10.1093/omcr/omac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/25/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
| | - Takahiko Fukuchi
- Department of Comprehensive Medicine 1, Division of General Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hitoshi Sugawara
- Department of Comprehensive Medicine 1, Division of General Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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9
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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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10
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Malek E, Faddoul DG, Baydoun H, Omeis I, Makki A. Reversible Acute Anterior Longitudinal Ligament Calcification With Retropharyngeal Inflammation. J Clin Rheumatol 2021; 27:e123-e125. [PMID: 30142115 DOI: 10.1097/rhu.0000000000000878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Mahajna H, Greenberg G, Lang A. A Rare Nonrecognized Cause of Dysphagia. Gastroenterology 2021; 160:e8-e9. [PMID: 32946902 DOI: 10.1053/j.gastro.2020.08.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/24/2020] [Indexed: 12/02/2022]
Affiliation(s)
| | - Gahl Greenberg
- Department of Diagnostic Imaging, Sheba Medical Center affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel
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12
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Siag K, Mazzawi S, Paker M, Biener R, Ghanayim R, Lumelsky D. Acute longus colli tendinitis and otolaryngology. Braz J Otorhinolaryngol 2020; 88:351-357. [PMID: 33342696 PMCID: PMC9422725 DOI: 10.1016/j.bjorl.2020.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/20/2020] [Accepted: 10/28/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Acute longus colli tendinitis is caused by calcium hydroxyapatite deposition in the tendon of the longus colli muscle with subsequent inflammation. The calcifications are commonly located at the superior oblique portion at the level of the C1-C2 vertebrae. The typical clinical presentation consists of acute neck pain, odynophagia, and painful limitation of neck range of motion. OBJECTIVES We will describe this disease with three that cases presented to our institution and compare the findings on imaging studies. METHODS We retrospectively reviewed the clinical data, radiological features, and laboratory reports of three patients diagnosed with acute longus colli tendinitis. Computed tomography and plain radiographs were reviewed and compared by a single radiologist. A contemporary review of the literature was conducted using PubMed (Medline), Embase, and Cochrane library databases. RESULTS Computed tomography showed greater sensitivity for the detection of the pathognomonic calcification than plain radiographs and facilitated the exclusion of other more severe conditions by following a systematic interpretation composed of five key elements. Plain radiographs showed non-specific signs of prevertebral soft tissue swelling and a decreased cervical lordotic curve. However, no calcification was identified on plain radiographs. The literature review revealed 153 articles containing 372 cases. Surgical or invasive procedures were mentioned in 13.7% of publications and were performed in 28 patients. CONCLUSIONS Acute longus colli tendinitis can mimic the clinical presentation of more severe conditions that the otolaryngologist may be required to evaluate, such as infectious, traumatic, and neoplastic diseases. Knowledge of this entity, with its pathognomonic imaging findings, can prevent misdirected medical therapy and unnecessary invasive procedures.
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Affiliation(s)
- Kfir Siag
- Emek Medical Center, Department of Otolaryngology Head and Neck Surgery, Afula, Israel.
| | - Salim Mazzawi
- Emek Medical Center, Department of Otolaryngology Head and Neck Surgery, Afula, Israel
| | - Miki Paker
- Emek Medical Center, Department of Otolaryngology Head and Neck Surgery, Afula, Israel
| | - Roy Biener
- Emek Medical Center, Department of Otolaryngology Head and Neck Surgery, Afula, Israel
| | - Rami Ghanayim
- Emek Medical Center, Department of Otolaryngology Head and Neck Surgery, Afula, Israel
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13
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Fieux M, Duret S, Tringali S. Low-grade fever and stiff neck. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:215-216. [PMID: 33077408 DOI: 10.1016/j.anorl.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M Fieux
- Service d'otologie et d'otoneurologie, Hospices Civils de Lyon, centre hospitalier Lyon Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
| | - S Duret
- Service d'otologie et d'otoneurologie, Hospices Civils de Lyon, centre hospitalier Lyon Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France; Service d'ORL et chirurgie cervico-faciale, centre hospitalier Lucien-Hussel, 38200 Vienne, France
| | - S Tringali
- Service d'otologie et d'otoneurologie, Hospices Civils de Lyon, centre hospitalier Lyon Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
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14
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Draghi F, Cocco G, Lomoro P, Bortolotto C, Schiavone C. Non-rotator cuff calcific tendinopathy: ultrasonographic diagnosis and treatment. J Ultrasound 2020; 23:301-315. [PMID: 31197633 PMCID: PMC7441123 DOI: 10.1007/s40477-019-00393-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/31/2019] [Indexed: 12/13/2022] Open
Abstract
Calcific tendinopathy is a condition that is related to the deposition of calcium, mostly hydroxyapatite crystals, within the tendons. The shoulder and the hip are commonly affected joints, but calcific tendinopathy may occur in any tendon of the body. While there is an extensive literature on the ultrasound diagnosis of calcific tendinopathy of the shoulder, there are only sporadic reports on other sites. This review combines the experience of our centers and a thorough analysis of the literature from the last 45 years (1972-2017) in order to highlight the localizations beyond the rotator cuff, their ultrasound characteristics and therapeutic possibilities.
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Affiliation(s)
- Ferdinando Draghi
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Giulio Cocco
- Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Via dei Vestini 31, 66100, Chieti, Italy
| | - Pascal Lomoro
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Chandra Bortolotto
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy.
| | - Cosima Schiavone
- Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Via dei Vestini 31, 66100, Chieti, Italy
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15
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Akaishi T, Miura K, Iduma M, Ishii T. Retropharyngeal calcific tendinitis: A rare, benign, but painful condition with stiff neck. J Gen Fam Med 2020; 21:274-276. [PMID: 33304727 PMCID: PMC7689232 DOI: 10.1002/jgf2.360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/19/2020] [Accepted: 06/24/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Tetsuya Akaishi
- Department of Education and Support for Regional Medicine Tohoku University Hospital Sendai Japan
| | - Keiki Miura
- Department of Orthopedic Surgery Tome City Hospital Tome Japan
| | - Masaaki Iduma
- Department of Internal Medicine Tome City Hospital Tome Japan
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine Tohoku University Hospital Sendai Japan
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16
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Salaffi F, Carotti M, Di Carlo M, Sessa F, Malavolta N, Polonara G, Giovagnoni A. Craniocervical junction involvement in musculoskeletal diseases: an area of close collaboration between rheumatologists and radiologists. Radiol Med 2020; 125:654-667. [DOI: 10.1007/s11547-020-01156-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
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17
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[Dysphagia in cervical spine diseases]. HNO 2019; 67:801-814. [PMID: 31485696 DOI: 10.1007/s00106-019-00738-7] [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: 10/26/2022]
Abstract
Dysphagia is a common symptom and can be indicative of a variety of heterogeneous diseases. "Classical" diseases of the head and neck region, such as acute tonsillitis, peritonsillar abscesses, diverticula, and benign or malignant tumors are common causes of dysphagia. However, it can also occur in the context of neurological diseases, e.g., as a result of stroke or as an age-related phenomenon (presbyphagia). Pathologies of the cervical spine can also be a cause of dysphagia. In this context, congenital or acquired diseases, inflammatory or degenerative processes, cervical spine surgery, and (malignant) masses of the cervical spine should be taken into account. Particular dysphagia with a positive history of previous operative interventions on the cervical spine or symptoms such as chronic back pain and trauma should give rise to consideration of a cervical spine-related cause.
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18
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Munson L, Funk MF, Perrault TA. Retropharyngeal Calcific Tendonitis in a Patient Seeking Chiropractic Care for Neck Pain: A Case Report. J Chiropr Med 2019; 17:275-282. [PMID: 30846921 DOI: 10.1016/j.jcm.2018.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/19/2018] [Accepted: 04/02/2018] [Indexed: 10/27/2022] Open
Abstract
Objective The purpose of this report is to describe the evaluation and treatment of a patient initially presenting for chiropractic care of neck pain (NP) who was subsequently diagnosed with retropharyngeal calcific tendonitis (RCT). Clinical Features A 53-year-old woman presented to a chiropractic office with severe idiopathic NP, loss of cervical mobility, and intermittent painful swallowing. She had a motor vehicle accident 6 months before with NP that resolved within a week without treatment. A brief examination and some manual palliative care were attempted by the chiropractor. Two days later, the patient developed severe NP and fever, sought emergency medical care on her own, and requested the chiropractor meet her at the hospital. The emergency physicians initially considered an infection, and antibiotics were provided along with oxycodone and naproxen sodium for pain. After advanced (computed tomography) imaging, RCT was diagnosed, and she was discharged the next day. Interventions and Outcome After being diagnosed, the patient's primary care provider prescribed prednisone and physical therapy. After 3 weeks, the patient stated her pain continued and she went for chiropractic care and was treated for mechanical neck pain with manipulation, manual muscle treatment, postural training, and rehabilitative exercises. Conclusion Practitioners should recognize the clinical presentation of RCT, order appropriate computed tomography imaging, and implement effective treatments. Although uncommon, RCT should be considered in patients with NP, limited mobility, and painful swallowing.
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Affiliation(s)
- Laura Munson
- University of Bridgeport College of Chiropractic, Bridgeport, Connecticut
| | - Matthew F Funk
- University of Bridgeport College of Chiropractic, Bridgeport, Connecticut
| | - Terence A Perrault
- University of Bridgeport College of Chiropractic, Bridgeport, Connecticut
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19
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Nakagami F, Hagiya H, Rakugi H. Acute Non-calcific Retropharyngeal Tendinitis. Intern Med 2018; 57:3499-3500. [PMID: 30101923 PMCID: PMC6306551 DOI: 10.2169/internalmedicine.1127-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Futoshi Nakagami
- Department of General Internal Medicine, Osaka University Medical Hospital, Japan
| | - Hideharu Hagiya
- Department of General Internal Medicine, Osaka University Medical Hospital, Japan
| | - Hiromi Rakugi
- Department of Geriatric Medicine, Osaka University Graduate School of Medicine, Japan
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20
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Naik PP, Savery N, Kuruvilla L, Nayakar G, Raghul T. Longus Colli Tendinitis: The Lost Twin of Retropharyngeal Abscess. Indian J Otolaryngol Head Neck Surg 2018; 71:771-775. [PMID: 31742062 DOI: 10.1007/s12070-018-1541-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/21/2018] [Indexed: 12/20/2022] Open
Abstract
Longus colli calcific tendinitis is a rare condition which mimics the alarming condition, retropharyngeal abscess. Clinically, the patient presents which acute cervical pain, dysphagia and fever. Since this condition is little known to otorhinolaryngologists, it is usually misdiagnosed as a retropharyngeal abscess which is more common. This is a case report of a 52 year old female who presented with complaints of neck pain and difficulty in swallowing along with fever which were acute in onset. Clinically, the symptoms overlapped with those of a retropharyngeal abscess. The diagnosis was confirmed as longus colli calcific tendinitis. Longus colli calcific tendinitis is a rare entity which can be diagnosed solely based on radiological investigation. The knowledge of this disease is crucial to otorhinolaryngolists as it avoids over treatment, unwarranted chance surgical exposure.
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Affiliation(s)
| | - Nishanth Savery
- Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Linu Kuruvilla
- Pondicherry Institute of Medical Sciences, Puducherry, India
| | | | - T Raghul
- Pondicherry Institute of Medical Sciences, Puducherry, India
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Uchida T, Kanzaki M, Kakumoto T, Uesaka Y. Longus Colli Tendinitis in a Patient Presenting with Neck Pain and Acute Systemic Inflammation. Intern Med 2018; 57:2759-2761. [PMID: 29709928 PMCID: PMC6191587 DOI: 10.2169/internalmedicine.0160-17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The diagnosis of longus colli tendinitis (LCT) is sometimes challenging, especially when laboratory data show marked inflammation and neuroimaging studies do not indicate calcification within the tendon of the longus colli muscles. We herein report a case of LCT that presented with elevated inflammation parameters without calcification on imaging. Findings characteristic of LCT, such as prevertebral hyperintensity areas on T2-weighted images and no signs of purulent diseases, informed our diagnosis of LCT. Enhanced computed tomography and magnetic resonance imaging are useful procedures when diagnosing LCT after ruling out other critical purulent diseases.
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Affiliation(s)
- Takayasu Uchida
- Department of Neurology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, Japan
| | - Mami Kanzaki
- Department of Neurology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, Japan
| | - Toshiyuki Kakumoto
- Department of Neurology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, Japan
| | - Yoshikazu Uesaka
- Department of Neurology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, Japan
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22
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Narváez J, Morales-Ivorra I, Martínez-Yelamos S, Narváez JA. Acute Calcific Tendinitis of the Longus Colli Muscle. Am J Med 2018; 131:e365-e366. [PMID: 29729242 DOI: 10.1016/j.amjmed.2018.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 10/17/2022]
Affiliation(s)
| | | | | | - Jose Antonio Narváez
- Department of Radiology, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
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23
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Suh B, Eoh J, Shin J. Clinical and Imaging Features of Longus Colli Calcific Tendinitis: An Analysis of Ten Cases. Clin Orthop Surg 2018; 10:204-209. [PMID: 29854344 PMCID: PMC5964269 DOI: 10.4055/cios.2018.10.2.204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/26/2018] [Indexed: 11/17/2022] Open
Abstract
Background Longus colli calcific tendinitis (LCCT) exhibits characteristic clinical features; thus, misidentification can be avoided once it is learned. There is a lack of reports on this disease. In this study, we analyzed the imaging and clinical features of LCCT in 10 patients. Methods We retrospectively reviewed the radiolographic findings, laboratory data and clinical features of 10 patients diagnosed with LCCT between January 2015 and June 2017. All patients were treated with medical treatment consisting of intravenous methylprednisolone 125 mg twice and oral nonsteroidal anti-inflammatory drug administration. Results On clinical findings, all 10 patients complained of severe posterior neck pain and cervical motion limitation. Odynophagia was present in nine patients. The mean time from symptom onset to hospital visit was 2.9 days. The mean time to symptom relief was 4.6 days. Of the 10 patients, three patients were admitted through the emergency room. There were five patients in the medical records who were transferred from another hospital. On the laboratory data, the mean value of C-reactive protein and erythrocyte sedimentation rate were 2.08 mg/dL (reference range, < 0.30 mg/dL) and 36.9 mm/hr (reference range, < 20 mm/hr), respectively. Leukocytosis was found in only two patients and fever was not present all patients. On radiographic findings, calcification was present on computed tomography images of all patients. The calcification was located at the lower part of the C1 arch, except for one case where calcification occurred in the anterolateral aspect of the C4–5 disc space. The mean value of the retropharyngeal space was 7.2 mm. Conclusions LCCT, a rare disease, has characteristic radiographic findings and clinical features. Understanding such characteristics of this disease can prevent unnecessary testing and misdiagnosis.
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Affiliation(s)
- Bogun Suh
- Spine Center and Department of Orthopaedic Surgery, Pohang Semyeong Christianity Hospital, Pohang, Korea
| | - Jaehyung Eoh
- Spine Center and Department of Orthopaedic Surgery, Pohang Semyeong Christianity Hospital, Pohang, Korea
| | - Jihoon Shin
- Spine Center and Department of Orthopaedic Surgery, Pohang Semyeong Christianity Hospital, Pohang, Korea
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24
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Raggio BS, Ficenec SC, Pou J, Moore B. Acute Calcific Tendonitis of the Longus Colli. Ochsner J 2018; 18:98-100. [PMID: 29559880 PMCID: PMC5855435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Acute calcific tendonitis of the longus colli (ACTLC) is an aseptic inflammatory response to deposition of calcium in the longus colli muscle tendons. Although reports in the literature are scarce, ACTLC likely represents an underreported disease process that routinely goes misdiagnosed. We report a case of ACTLC and provide a brief review of the literature. CASE REPORT A 45-year-old otherwise healthy female presented with a 3-day history of progressive neck pain, decreased neck mobility, and odynophagia. She exhibited tenderness over the right posterolateral neck with limited neck flexion and rotation. Flexible fiber-optic laryngoscopy revealed moderate posterior pharyngeal wall edema extending from the palatal-pharyngeal sphincter down to the level of the epiglottis. A computed tomography (CT) scan of the neck with contrast revealed an amorphous calcification in the longus colli muscle and a prevertebral fluid collection without rim enhancement. A diagnosis of ACTLC was presumed. The patient was successfully managed with nonsteroidal antiinflammatory drugs, corticosteroids, and antibiotics and reported complete resolution of symptoms on follow-up. CONCLUSION The clinical presentation and laboratory findings of ACTLC are nonspecific; however, a CT scan revealing a calcific deposition in the retropharyngeal space confirms the diagnosis. Spontaneous resolution during the course of several weeks warrants conservative treatment with analgesia and antiinflammatory medications. Awareness of ACTLC must be increased to avoid diagnostic errors and prevent unnecessary medical interventions.
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Affiliation(s)
- Blake S. Raggio
- Department of Otolaryngology, Tulane University Medical Center, New Orleans, LA
| | | | - Jason Pou
- Department of Otolaryngology, Tulane University Medical Center, New Orleans, LA
| | - Brian Moore
- Department of Otolaryngology, Ochsner Clinic Foundation, New Orleans, LA
- The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA
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25
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Alamoudi U, Al-Sayed AA, AlSallumi Y, Rigby MH, Taylor SM, Hart RD, Trites JRB. Acute calcific tendinitis of the longus colli muscle masquerading as a retropharyngeal abscess: A case report and review of the literature. Int J Surg Case Rep 2017; 41:343-346. [PMID: 29145108 PMCID: PMC5686463 DOI: 10.1016/j.ijscr.2017.10.063] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/29/2017] [Accepted: 10/30/2017] [Indexed: 11/25/2022] Open
Abstract
The longus colli muscle is situated on the anterior surface of C1-C2 disk space. Calcific tendinitis of the longus colli muscle is a reactive self-limiting inflammatory response to the subacute deposition of calcium hydroxyapatite crystals on the tendon of the muscle. The clinical presentation is usually mistaken with other serious conditions, such as a retropharyngeal abscess, disk herniation, neck tumor or trauma. The importance of recognizing this pathology lies in preventing its misdiagnosis and mismanagement. This condition is usually managed conservatively with nonsteroidal anti-inflammatory drugs (NSAIDs).
Introduction Acute calcific longus colli tendinitis, also known as retropharyngeal or acute calcific prevertebral tendinitis, is a reactive self-limiting inflammatory response to acute or subacute deposition of amorphous calcium hydroxyapatite crystals in the tendons of the longus colli muscle, anterior to the C1–C2 disk space. Case presentation A 53-year-old man presented with a complaint of neck pain and odynophagia over a few days. Blood test findings showed mild leukocytosis and elevated C-reactive protein level. Computed tomography findings showed mild edematous prevertebral thickening involving the retropharyngeal space, predominantly on the left side, with no appreciable surrounding peripheral enhancement. A small amount of linear calcification/ossification involving the superior fibers of the left longus colli muscle, anterior to the C1 arch were also noted. Discussion The patient’s presentation could be easily misdiagnosed as a retropharyngeal abscess. However, the presence of subtle findings on CT would lead to the correct diagnosis. The management of this condition is mainly with nonsteroidal anti-inflammatory drugs. Conclusion This study presents the characteristic radiological features of retropharyngeal calcific tendinitis. These features are subtle and could be missed. Once an accurate diagnosis is made, treatment with nonsteroidal anti-inflammatory drugs is indicated. The purpose of this case report is to highlight this rare condition’s diagnosis and management.
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Affiliation(s)
- Uthman Alamoudi
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada; Department of Otolaryngology, Hail University, Hail, Saudi Arabia.
| | - Ahmed A Al-Sayed
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada; Department of Otorhinolaryngology - Head & Neck Surgery, Department of Otolaryngology, King Saud University, Riyadh, Saudi Arabia
| | - Yasser AlSallumi
- Department of Radiology, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada; Department of Medical Imaging, Department of Radiology, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Matthew H Rigby
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada
| | - S Mark Taylor
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada
| | - Robert D Hart
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada
| | - Jonathan R B Trites
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada
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Kim YJ, Park JY, Choi KY, Moon BJ, Lee JK. Case reports about an overlooked cause of neck pain: calcific tendinitis of the longus colli: Case reports. Medicine (Baltimore) 2017; 96:e8343. [PMID: 29145245 PMCID: PMC5704790 DOI: 10.1097/md.0000000000008343] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
STUDY DESIGN Case description. OBJECTIVE Acute calcific tendinitis of the longus colli muscle is a rare clinical entity that causes severe neck pain. This entity is not well recognized due to its nonspecific presentation such as acute neck pain, neck stiffness, and odynophagia. The importance of this disease with a review of the literature is presented. SUMMARY OF BACKGROUND DATA Acute calcific tendinitis of the longus colli muscle is an inflammatory condition caused by deposition of calcium hydroxyapatite in the superior oblique tendon fibers of the longus colli muscle. It can be misdiagnosed as other life-threatening conditions including retropharyngeal abscess, resulting in unnecessary medical or surgical interventions. METHODS We retrospectively reviewed the clinical data, radiological features, and laboratory reports of 8 patients who were diagnosed with acute calcific tendinitis of the longus colli muscle and seen at our institution between April 2008 and March 2015 in this article. We describe the clinical presentation, diagnosis, and treatment of acute calcific tendinitis of the longus colli muscle. RESULTS There were 5 men and 3 women who ranged in age from 41 to 49 years (mean age: 44.5 years). The associated symptoms included neck pain, stiffness, odynophagia, and headache. The duration of symptoms varied from 2 days to 1 week. All patients showed calcific deposition inferior to the anterior arch of the atlas, and prevertebral effusion extending from C1 to C4. All patients were treated with NSAIDs and immobilization with a cervical brace, and most patients showed complete resolution of symptoms within 1 week. CONCLUSION We report 8 cases of acute calcific tendinitis of the longus colli, and describe the symptoms and radiological findings in detail. Awareness of this rare, benign, and self-limiting disease entity with characteristic radiologic findings is essential for early diagnosis and to avoid unnecessary medical and surgical interventions.
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27
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Abdelbaki A, Abdelbaki S, Bhatt N, Gupta N, Li S, Ghasemiesfe A, Kumar Y. Acute Calcific Tendinitis of the Longus Colli Muscle: Report of Two Cases and Review of the Literature. Cureus 2017; 9:e1597. [PMID: 29067221 PMCID: PMC5652888 DOI: 10.7759/cureus.1597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Acute calcific tendinitis (ACT) of the longus colli muscle is a rare cause of debilitating neck pain. The ACT is presumed to be an aseptic inflammatory process of the superior oblique tendons of the longus colli muscle. It is often confused with other more concerning conditions including trauma, epidural abscess, disc herniation, and neoplasm. We present two cases of ACT and a brief literature review to stress the risk of misdiagnosis. A 38-year-old male presented with neck pain and stiffness accompanied by dysphagia. Computed tomography (CT) scan was done and the diagnosis was secured by demonstrating calcifications at the C1-C2 level as well as the retropharyngeal effusion. A 53-year-old female was also complaining of neck pain and dysphagia. The CT scan demonstrated similar findings and the diagnosis was again clinched. Awareness of this unusual entity is essential to prevent unnecessary interventions.
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Affiliation(s)
| | | | | | | | - Shuo Li
- Department of Radiology, Yale New Haven Health System
| | | | - Yogesh Kumar
- Department of Radiology, Yale New Haven Health System
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28
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Boardman J, Kanal E, Aldred P, Boonsiri J, Nworgu C, Zhang F. Frequency of acute longus colli tendinitis on CT examinations. Emerg Radiol 2017; 24:645-651. [PMID: 28744692 PMCID: PMC5681978 DOI: 10.1007/s10140-017-1537-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 07/11/2017] [Indexed: 11/26/2022]
Abstract
Purpose We attempted to determine the frequency of acute longus colli tendinitis on diagnostic CT imaging performed at a large multicenter health care system. By correlating with the pre-imaging clinical information, we investigated which patient presentations should lead the radiologist to increased suspicion for this condition. Methods Images from a total of 8101 adult CT examinations of the neck and cervical spine performed over a 3-month period were evaluated by researchers independent of the original clinical report. Clinical information available at the time of imaging was reviewed and assigned to one of five categories. Frequency of the condition was calculated by sex and clinical presentation. This retrospective study with waiver of consent and waiver of HIPPA was approved by our IRB. Results Nine positive scans were found for an overall frequency of 1.1 per 1000 examinations. The frequency was significantly higher (11.4 per thousand) on scans performed of patients presenting without history of recent trauma, concern for tumor, suspected postoperative complication, or clinical signs of infection localized to the neck. Although frequency in males was higher than in females, this did not reach statistical significance. In no positive or negative case was longus colli tendinitis considered in the pre-imaging documentation. Conclusions Findings of acute longus colli tendinitis on CT examination generally occur in the absence of prior mention of this condition in the medical record. The radiologist should be particularly alert for this diagnosis when a patient presents with rapid-onset neck pain without a clear history of recent trauma or other etiologies.
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Affiliation(s)
- John Boardman
- Radiology Suite, 201 East Wing, 200 Lothrop St, Pittsburgh, PA 15213 USA
| | - Emanuel Kanal
- Radiology Suite, 201 East Wing, 200 Lothrop St, Pittsburgh, PA 15213 USA
| | - Patrick Aldred
- Radiology Suite, 200 Lothrop St, Pittsburgh, PA 15213 USA
| | - Joseph Boonsiri
- Department of Neuroradiology, NYU, 660 First Ave., 2nd Floor, New York, NY 10016 USA
| | | | - Feng Zhang
- Department of Radiology Education, Stanford University Medical Center, 300 Pasteur Dr., H1330, MC:5621, Stanford, CA 94305-5621 USA
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29
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Colella DM, Calderón Sandoval F, Powers DW, Patel N, Sobrado J. A Rare Cause of Dysphagia to Remember: Calcific Tendinitis of the Longus Colli Muscle. Case Rep Gastroenterol 2017; 10:755-759. [PMID: 28100997 PMCID: PMC5216232 DOI: 10.1159/000452199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 10/03/2016] [Indexed: 12/02/2022] Open
Abstract
Longus colli tendinitis (LCT) is an acute inflammatory condition with symptoms typically consisting of acute neck pain and stiffness with or without dysphagia. Once more severe etiologies for these symptoms are ruled out, this self-limiting condition usually resolves spontaneously with nonsteroidal anti-inflammatory drugs and corticosteroids. We present a case of LCT that presented as acute neck pain, dysphagia, and odynophagia that rapidly resolved once diagnosed and treated with anti-inflammatory agents. Though exceedingly rare, LCT must be considered in the differential diagnosis of acute neck pain, dysphagia, and odynophagia when more common etiologies do not correlate with the clinical presentation.
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Affiliation(s)
- Dominic M Colella
- Department of Gastroenterology, Larkin Hospital, Nova Southeastern University, South Miami, FL, USA
| | | | - David W Powers
- Department of Gastroenterology, Larkin Hospital, Nova Southeastern University, South Miami, FL, USA
| | - Nimal Patel
- Department of Gastroenterology, Larkin Hospital, Nova Southeastern University, South Miami, FL, USA
| | - Javier Sobrado
- Department of Gastroenterology, Larkin Hospital, Nova Southeastern University, South Miami, FL, USA
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30
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Verhoeven F, Sondag M, Aubry S, Prati C, Wendling D. Une odynophagie au cristal. Presse Med 2016; 45:801-2. [DOI: 10.1016/j.lpm.2016.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 06/15/2016] [Accepted: 07/18/2016] [Indexed: 11/26/2022] Open
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Oh JY, Lim JH, Kim YS, Kwon YE, Yu JY, Lee JH. Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome. Korean J Pain 2016; 29:48-52. [PMID: 26839671 PMCID: PMC4731552 DOI: 10.3344/kjp.2016.29.1.48] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 10/19/2015] [Accepted: 10/20/2015] [Indexed: 11/20/2022] Open
Abstract
Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendinitis, who complained of posterior neck pain, initially diagnosed and treated as a myofascial neck pain syndrome.
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Affiliation(s)
- Ji Youn Oh
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Jin Hun Lim
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Yong Seok Kim
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Young Eun Kwon
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Jae Yong Yu
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Jun Hak Lee
- Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea
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Abstract
We present a case of neck pain in a middle-aged woman, initially attributed to a retropharyngeal infection and treated with urgent intubation. With the help of computed tomography, the diagnosis was later revised to acute prevertebral calcific tendinitis, a self-limiting condition caused by abnormal calcium hydroxyapatite deposition in the longus colli muscles. It is critical to differentiate between these two disease entities due to dramatic differences in management. A discussion of acute prevertebral calcific tendinitis and its imaging findings is provided below.
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Affiliation(s)
- Alexander Tamm
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Caroline C Jeffery
- Division of Otolaryngology - Head and Neck Surgery, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Khalid Ansari
- Division of Otolaryngology - Head and Neck Surgery, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Sandeep Naik
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, Alberta, Canada
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Yaylacı S, Öztürk TC, Aksoy E, Koçyigit A, Yılmaz A, Karaarslan E. Retropharyngeal calcific tendinitis: Report of two cases. J Emerg Trauma Shock 2015; 8:119-20. [PMID: 25949045 PMCID: PMC4411574 DOI: 10.4103/0974-2700.145408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Serpil Yaylacı
- Department of Emergency Medicine, Acibadem University, School of Medicine, Istanbul, Turkey
| | - Tuba Cimilli Öztürk
- Fatih Sultan Mehmet Education And Research Hospital, Emergency Medicine Clinic, Istanbul, Turkey
| | - Elif Aksoy
- Department of Otorhinolaryngology, Acibadem University, School of Medicine, Istanbul, Turkey
| | - Ali Koçyigit
- Department of Radiology, Pamukkale University, School of Medicine, Denizli, Turkey
| | - Atakan Yılmaz
- Department of Emergency Medicine, Tekirdağ State Hospital, Tekirdağ, Turkey
| | - Ercan Karaarslan
- Department of Radiology, Acibadem University, School of Medicine, Istanbul, Turkey E-mail:
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34
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Suyama Y, Kishimoto M, Nozaki T, Deshpande GA, Okada M. Acute Calcific Tendinitis of the Longus Colli Muscle. Arthritis Rheumatol 2015; 67:2446. [PMID: 25941110 DOI: 10.1002/art.39184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 04/28/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Yasuhiro Suyama
- St. Luke's International Hospital, and St. Luke's International University
| | | | - Taiki Nozaki
- St. Luke's International Hospital, and St. Luke's International University
| | | | - Masato Okada
- St. Luke's International Hospital, and St. Luke's International University, Tokyo, Japan
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35
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Affiliation(s)
- Tsukasa Nozu
- Department of Regional Medicine and Education, Asahikawa Medical University, Japan
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36
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Chen CH, Lu YC, Wong TY. Acute calcific prevertebral tendinitis: rare cause of neck pain. Acute Med Surg 2014; 2:199-201. [PMID: 29123721 DOI: 10.1002/ams2.92] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 09/17/2014] [Indexed: 11/10/2022] Open
Abstract
Case We report a case of acute calcific prevertebral tendinitis and discuss the clinical signs, symptoms, and radiologic findings of the disease. Outcome This 47-year-old man suffered from neck pain, odynophagia, and sore throat for 2 days. Acute calcific prevertebral tendinitis was noted. This disease, brought on by prolonged minor repetitive tendon injury, is an often overlooked cause of acute neck pain. The typical radiologic appearances of the disease include the calcification of the anterior surface of the C1-C2 spine and smooth soft tissue swelling over the retropharyngeal space. Conclusion Generally this disease is benign and may be misdiagnosed as deep neck infection. Drainage on this patient would be considered malpractice.
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Affiliation(s)
- Chia-Hsi Chen
- Department of Emergency Medicine St. Martin De Porres Hospital Chiayi Taiwan
| | - Ying-Chou Lu
- Department of Otolaryngology St. Martin De Porres Hospital Chiayi Taiwan
| | - Tak-Yee Wong
- Department of Diagnostic Radiology St. Martin De Porres Hospital Chiayi Taiwan
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Inokuchi R, Wada T, Ohta F, Sonoo T, Aoki Y, Asada T, Hiruma T, Shinohara K, Nakajima S, Yahagi N. Images in emergency medicine. A healthy young man with neck sprain. Retropharyngeal tendonitis. Ann Emerg Med 2014; 63:86, 95. [PMID: 24355370 DOI: 10.1016/j.annemergmed.2013.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ryota Inokuchi
- Department of Emergency, Shirane Tokushukai Hospital, Yamanashi, Japan; Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoki Wada
- Department of Emergency, Shirane Tokushukai Hospital, Yamanashi, Japan; Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Fumihito Ohta
- Department of Neurosurgery, Shirane Tokushukai Hospital, Yamanashi, Japan
| | - Tomohiro Sonoo
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuta Aoki
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshifumi Asada
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Takahiro Hiruma
- Department of Emergency, Shirane Tokushukai Hospital, Yamanashi, Japan; Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Kazuaki Shinohara
- Department of Emergency and Critical Care Medicine, Ohta Nishinouchi Hospital, Fukushima, Japan
| | - Susumu Nakajima
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Naoki Yahagi
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
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Roldan CJ, Carlson PJ. Longus colli tendonitis, clinical consequences of a misdiagnosis. Am J Emerg Med 2013; 31:1538.e1-2. [PMID: 23932124 DOI: 10.1016/j.ajem.2013.05.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 05/15/2013] [Indexed: 11/29/2022] Open
Abstract
Numerous pathologies diagnosed in the emergency department (ED) are treated with invasive procedures involving anesthetic and surgical risks. Retropharyngeal abscess is a serious condition requiring emergent treatment, often in need of trans-oral incision and drainage under general anesthesia. A misdiagnosis, especially after surgical treatment, might generate undesirable consequences, more so if the final diagnosis is a non-surgical pathology such as longus colli (LC) tendonitis. To discuss the etiology, differential diagnosis and treatment of LC tendonitis, a clinical condition still misdiagnosed despite advanced imaging techniques. A middle-aged man presented to a satellite ED with sore throat, neck pain and stiffness. A computed tomography (CT) scan of the neck with intravenous contrast was read as retropharyngeal abscess. He was transferred to our ED after acceptance by ear-nose-throat (ENT) surgery. He was scheduled for open incision and drainage under general anesthesia. A detailed evaluation by our ED staff revealed a nontoxic patient with no compromise of the airway. His physical exam was unrevealing and a second review of the CT demonstrated typical radiological signs for LC tendonitis. After a discussion with ENT the patient was discharged home on anti-inflammatory medications and oral steroids. He recovered well and no further intervention was needed. Longus colli tendonitis is a rare condition that mimics emergent surgical conditions. Emergency physicians are qualified to make a clinical and radiological diagnosis. While CT scan can provide a diagnosis, the primary evaluation tool is an adequate medical interview and physical exam.
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Affiliation(s)
- Carlos J Roldan
- Department of Emergency Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Memorial Hermann-Texas Medical Center, Houston, TX 77030, USA; Lyndon Baines Johnson General Hospital, Houston, TX 77030, USA; The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Retropharyngeal calcific tendinitis mimicking a retropharyngeal phlegmon. Case Rep Otolaryngol 2013; 2013:912628. [PMID: 23862089 PMCID: PMC3686063 DOI: 10.1155/2013/912628] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 04/30/2013] [Indexed: 11/17/2022] Open
Abstract
Background. Acute retropharyngeal tendinitis is a little known but not an uncommon condition. It was first described by Hartley in 1964 as an inflammation of the longus colli muscle secondary to calcium crystals deposition on its insertion. The calcifications are mostly located on the oblique portion of the muscle at the level of C1-C2. Methods. We will describe this disease through 4 cases that presented in our institution. Results. The most common symptoms are severe neck pain, odynophagia, and a painful restriction of neck movement. It is associated with mild fever and inflammatory lab findings such as a slight elevation of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. CT scan is recommended as the first-line imaging modality to establish a diagnosis. Treatments consist of NSAIDs and analgesics to accelerate the healing process. If symptoms are severe, a course of corticosteroids is required. Conclusion. Since the clinical and laboratory findings of this condition and those of a retropharyngeal abscess overlap, it is important to establish the right diagnosis in order to prevent more invasive procedures. A good knowledge of this clinical entity by otolaryngologists would prevent delays in hospital discharge and unnecessary anxiety.
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Horowitz G, Ben-Ari O, Brenner A, Fliss DM, Wasserzug O. Incidence of retropharyngeal calcific tendinitis (longus colli tendinitis) in the general population. Otolaryngol Head Neck Surg 2013; 148:955-8. [PMID: 23525848 DOI: 10.1177/0194599813482289] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the incidence of retropharyngeal calcific tendinitis (longus colli tendinitis) in a general urban adult population. STUDY DESIGN Observational study in a municipal medical center. SETTING Single tertiary referral center. METHODS All symptomatic patients with a differential diagnosis of retropharyngeal calcific tendinitis underwent fiber-optic assessment, laboratory studies, and imaging studies. The main outcome measure was the incidence of retropharyngeal calcific tendinitis. RESULTS Thirteen patients with symptoms suggestive of retropharyngeal calcific tendinitis were evaluated in our institution between January 2008 and December 2011. Final diagnosis was made by means of a computed tomographic scan: 8 patients had retropharyngeal calcific tendinitis, 1 had retropharyngeal abscess, and the remaining 4 had other deep neck infections. The mean annual crude retropharyngeal calcific tendinitis incidence was 0.50 cases per 100,000 person-years, and the standardized incidence was 1.31 for the age-matched population. CONCLUSIONS Retropharyngeal calcific tendinitis is not a rare disease and is probably underdiagnosed because symptoms are nonspecific, treating physicians are often unfamiliar with this entity, and it is a self-limiting pathology.
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Affiliation(s)
- Gilad Horowitz
- Department of Otolaryngology, Head & Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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Terao K, Kusunoki T, Mori K, Murata K, Doi K. A Case of Calcific Retropharyngeal Tendinitis: The Significance of an Early Diagnosis. EAR, NOSE & THROAT JOURNAL 2013. [DOI: 10.1177/014556131309200210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The clinical presentation of calcific retropharyngeal tendinitis, a rare entity, can mimic more serious disorders. We describe the case of a 35-year-old man who was referred to us for evaluation of a suspected retropharyngeal abscess. At presentation, the patient reported severe cervical pain and stiffness. He exhibited mild fever, torticollis, and a moderately elevated white blood count; no swelling of the retropharyngeal wall was observed. Based on the results of plain radiography and computed tomography (CT), we diagnosed the patient with calcific retropharyngeal tendinitis. He was treated with a 7-day course of a nonsteroidal anti-inflammatory drug and a 3-day course of a steroid, and he recovered well. We suggest that the true incidence of calcific retropharyngeal tendinitis is actually higher than what is generally believed because this diagnosis is frequently missed. Contrast-enhanced CT can aid in diagnosing calcific retropharyngeal tendinitis. CT should be performed in patients who present with nonspecific symptoms such as severe neck pain, sore throat, odynophagia, and mild fever.
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Affiliation(s)
- Kyoichi Terao
- Department of Otolaryngology, Kinki University Faculty of Medicine, Osaka, Japan
| | | | - Kazunori Mori
- Department of Otolaryngology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Kiyotaka Murata
- Department of Otolaryngology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Katsumi Doi
- Department of Otolaryngology, Kinki University Faculty of Medicine, Osaka, Japan
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Yoon HJ, Son C, Lee S, Joo K, Kim TH. A Case of Retropharyngeal Calcific Tendinitis in a Patient with Ankylosing Spondylitis. JOURNAL OF RHEUMATIC DISEASES 2013. [DOI: 10.4078/jrd.2013.20.6.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hyae Jin Yoon
- Department of Internal Medicine, Hanyang University Collegy of Medicine, Seoul, Korea
| | - Changnam Son
- Department of Internal Medicine, Hanyang University Collegy of Medicine, Seoul, Korea
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Seunghun Lee
- Department of Radiology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Kungbin Joo
- Department of Radiology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Tae Hwan Kim
- Department of Internal Medicine, Hanyang University Collegy of Medicine, Seoul, Korea
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
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Acute calcific tendinitis of the longus colli muscle: case report and review of the literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2012. [PMID: 23179983 DOI: 10.1007/s00586-012-2584-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Acute calcific tendinitis of the longus colli muscle (or retropharyngeal tendinitis) is an aseptic inflammatory process characterized by acute posterior neck pain, neck stiffness and dysphagia or odynophagia. Awareness of its existence is crucial in the differential diagnosis, because many other conditions, such as retropharyngeal abscess, meningitis or disc herniation, show similar clinical features. We present a case exhibiting an uncommon symptom (torticollis) and a brief literature review to emphasize the risk of misdiagnosis. METHODS A 36-year-old woman presented with neck stiffness and torticollis accompanied by dysphagia and prevertebral space sensitivity on the second day. RESULTS The diagnosis was established by computed tomography (CT), the gold standard for identifying the presence of prevertebral oedema and calcific deposition associated with retropharyngeal tendinitis. Treatment with NSAIDs and low doses of corticosteroids relieved the symptoms within 48 h. CONCLUSIONS Retropharyngeal tendinitis is an underreported entity in the literature and orthopaedists should become aware of its existence. Misdiagnosis of this important mimicker may lead to unnecessary antibiotics administration and interventions in the retropharyngeal space.
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Unknown case: part 2. Acute neck pain in a 78-year-old man: a case presentation of retropharyngealcalcific tendinitis. Spine (Phila Pa 1976) 2012; 37:1634-5. [PMID: 21971122 DOI: 10.1097/brs.0b013e3182349a32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Coulier B, Macsim M, Desgain O. Retropharyngeal calcific tendinitis—longus colli tendinitis—an unusual cause of acute dysphagia. Emerg Radiol 2011; 18:449-51. [DOI: 10.1007/s10140-011-0959-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 05/06/2011] [Indexed: 11/30/2022]
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An interesting case of nuchal rigidity. Can J Neurol Sci 2011; 38:516-7. [PMID: 21515516 DOI: 10.1017/s0317167100011975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 34 year-old female without prior relevant medical history presented to our emergency room with a two-day history of neck pain, odynophagia and elevated body temperature up to 38.2° C. Her general practitioner had started the patient on antibiotic treatment with ciprofloxacin and referred her to our emergency department for further diagnostic workup and treatment of suspected meningitis. Initial neurological examination revealed neck rigidity and head pain without further focal neurological signs. Body temperature was 37.7 °C, blood analyses revealed a normal leukocyte count (8.900/μl) and normal C-reactive protein (<0.3mg/dl), blood cultures were sterile. Lumbar puncture was without pathological findings (<1 leukocytes/μl, normal levels for glucose, lactate and protein). Cervical magnetic resonance imaging could rule out osseous injury and cervical myelopathy, however a small prevertebral, retropharyngeal fluid collection was visible (Figure 1a-c). This prompted the diagnosis of acute retropharyngeal calcific tendinitis (RCT). This diagnosis was confirmed by conventional x-ray showing the presence of a characteristic amorphous calcification in the retropharyngeal space anterior to the C1-C2 segments (Figure 1d). Treatment with i.v. methylprednisolone (250mg) was started and pain was reduced shortly after the first infusion. The patient was discharged on tapered oral methylprednisolone and non-steroidal anti-inflammatory drug (NSAID) treatment. Symptoms resolved completely within a week.
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