Acute Calcific Retropharyngeal Tendinitis with Eggshell-like Calcification: Case Report and Literature Review on Time-course Changes in Imaging Findings.

Norio Yamamoto,Yuzuru Matsui,Toshifumi Ozaki,Takashi Watari,Keisuke Kawasaki

doi:10.7759/cureus.7611

Abstract

Acute calcific retropharyngeal tendinitis is a rare disease, and few studies have reported the radiological findings of its time-course in detail. These radiological findings vary according to the calcific stage. We report a case of acute calcific retropharyngeal tendinitis with eggshell-like calcification detected on follow-up computed tomography (CT). We also review pertinent literature on calcific retropharyngeal tendinitis, with a focus on time-course changes in imaging findings.A 54-year-old Japanese woman presented with acute severe neck pain. She also had a limited range of motion in the rotation of her neck and moderate pain and discomfort during swallowing. Plain radiographs of the cervical spine showed no apparent abnormality. CT revealed massive retropharyngeal calcification in front of the C1-C2 vertebrae. The patient was diagnosed with acute calcific retropharyngeal tendinitis and treated with a soft collar and non-steroidal anti-inflammatory drugs. Two weeks later, the neck pain and dysphagia improved. At the one-month follow-up, CT showed residual marginal calcification, which was diminishing in size, suggesting eggshell-like calcification.We believe that although the eggshell calcification appearance is extremely rare, it is important to note this atypical presentation of acute calcific retropharyngeal tendinitis.

Highlights

Acute calcific retropharyngeal tendinitis is a reactive, self-limiting inflammatory response to the acute deposition of calcium hydroxyapatite crystals in the tendons of the longus colli muscle at the anterior C1-C2 [1]
We believe that the eggshell calcification appearance is extremely rare, it is important to note this atypical presentation of acute calcific retropharyngeal tendinitis
We report a case of acute calcific retropharyngeal tendinitis with eggshell calcification, which was detected on follow-up computed tomography (CT)

Summary

Introduction

Acute calcific retropharyngeal tendinitis is a reactive, self-limiting inflammatory response to the acute deposition of calcium hydroxyapatite crystals in the tendons of the longus colli muscle at the anterior C1-C2 [1]. We review the pertinent literature on calcific retropharyngeal tendinitis, with a focus on time-course changes in imaging findings. How to cite this article Yamamoto N, Watari T, Kawasaki K, et al (April 10, 2020) Acute Calcific Retropharyngeal Tendinitis with Eggshell-like Calcification: Case Report and Literature Review on Time-course Changes in Imaging Findings. Owing to suspicion of emergent diseases, such as a retropharyngeal abscess, CT of the neck was performed It revealed massive retropharyngeal calcification with its longest diameter (18 mm) in front of the C1-C2 vertebrae (Figure 2). It was inhomogeneous and irregularly shaped with associated soft tissue swelling. A followup CT showed residual marginal calcification, which was diminishing in size, suggesting an eggshell-like calcification (Figure 4)

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