Acute Retropharyngeal Calcific Tendinitis Research Articles

Acute calcific retropharyngeal tendinitis: a three-case series and a literature review

Acute retropharyngeal tendinitis is a rare, self-limiting, benign condition that is poorly described in the literature. It is clinically characterized by neck pain and stiffness and either dysphagia or odynophagia. Diagnosis depends on clinical suspicion and imaging examination (computed tomography of the cervical spine is the gold standard), with calcification found in the anterior region of the first and second vertebrae. The disease usually presents good clinical course, with satisfactory response to the use of either non-steroidal anti-inflammatory drugs or corticosteroids, with remission of symptoms in days to weeks and of the calcification process in weeks to months.

Acute calcific retropharyngeal tendinitis

A 44-year-old man with a 3-day history of limited range of motion of the bilateral shoulders, neck pain, dysphagia and mild fever presented to our emergency department. He had no...

Just another case of neck pain? A case report of acute retropharyngeal calcific tendinitis.

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the ‘Save PDF’ action button.

Acute Retropharyngeal Calcific Tendinitis or Calcium Hydroxyapatite Deposits in Longus Colli Muscle

Acute retropharyngeal calcific tendinitis, also called calcium hydroxylapatite deposition disease, is a little known entity that causes pain and neck stiffness associated with odynophagia. Radiographically, it manifested with calcium deposits and an edematization of retropharyngeal soft tissues. Retropharyngeal impacting typically occurs to the long neck muscle tendon insertion or longus colli, although it is rarely described, in the literature. We present a clinical case treated in the Department of Traumatology and Orthopaedic Surgery of Hospital Clinico Universitario of Santiago de Compostela (La Coruna, Spain), discussing the clinical-radiological characteristics and treatment according to the little existing literature on the subject. After the analysis of the data obtained from the review of this case, we can conclude that the most important element for the diagnosis of this entity is the knowledge of its existence and recognition of its characteristics in plain X-ray and CT. It is self-limited and her treatment consists of anti-inflammatory agents, non-steroidal and neck brace immobilization. J Med Cases. 2017;8(2):63-66 doi: https://doi.org/10.14740/jmc1650w

Severe Neck Pain in Older Patients

Many of the diseases can cause severe neck pain in older patients. 10% of people will have neck pain in a life time. The most common causes are axial pain, whiplash-associated disorder, and cervical radiculopathy. Most cases without trauma, motor and/or sensory changes, and radiological abnormalities were diagnosed as axial pain. To date, crowned dens syndrome (CDS) and acute calcific retropharyngeal tendinitis (ACRT) have been almost considered as the main causes of acute neck pain in the elderly without trauma.

Acute Retropharyngeal Calcific Tendinitis or Calcium Hydroxyapatite Deposits in Longus Colli Muscle

Acute retropharyngeal calcific tendinitis, also called calcium hydroxylapatite deposition disease, is a little known entity that causes pain and neck stiffness associated with odynophagia. Radiographically, it manifested with calcium deposits and an edematization of retropharyngeal soft tissues. Retropharyngeal impacting typically occurs to the long neck muscle tendon insertion or longus colli, although it is rarely described, in the literature. We present a clinical case treated in the Department of Traumatology and Orthopaedic Surgery of Hospital Clinico Universitario of Santiago de Compostela (La Coruna, Spain), discussing the clinical-radiological characteristics and treatment according to the little existing literature on the subject. After the analysis of the data obtained from the review of this case, we can conclude that the most important element for the diagnosis of this entity is the knowledge of its existence and recognition of its characteristics in plain X-ray and CT. It is self-limited and her treatment consists of anti-inflammatory agents, non-steroidal and neck brace immobilization. J Med Cases. 2017;8(2):63-66 doi: https://doi.org/10.14740/jmc1650w

咽後膿瘍と鑑別を要した石灰沈着性頸長筋腱炎の3例

Acute calcific retropharyngeal tendinitis is an inflammation of the longus coli muscle characterized by the acute onset of neck pain, swallowing pain, and limitations of neck movement. Although symptoms subside spontaneously within one to two weeks, many cases are treated with antibiotics because clinical outcomes are similar to a severe infection of the retropharyngeal area such as a retropharyngeal abscess. We report herein on 3 cases of acute calcific retropharyngeal tendinitis. The first and second cases were hospitalized, had many examinations and were diagnosed retrospectively. The third patient was treated as an outpatient after a CT scan. Typical CT imaging shows prevertebral soft-tissue swelling without ring enhancement, and amorphous calcification just anterior to the atlanto-axial joint, allowing us early diagnosis.

Less known non-infectious and neuromusculoskeletal system-originated anterolateral neck and craniofacial pain disorders

Pain syndromes of neuromusculoskeletal origin are not well-known by most of the clinicians working on head and neck area. As a result, most of the patients with these syndromes are either overlooked without having any treatment or they inappropriately have antibiotic treatments or surgical interventions such as dental extractions and tonsillectomies. Better recognition of the pain syndromes of the neck and face region or entities related to neuromusculoskeletal system may result in more appropriate and effective management of such conditions while avoiding unnecessary medical and surgical treatments. In this review, causes, clinical characteristics, diagnostic and treatment modalities of relatively less known craniofacial and neck pain entities including Eagle syndrome, carotidynia, glossopharyngeal neuralgia, superior laryngeal neuralgia, hyoid bone syndrome, acute calcific retropharyngeal tendinitis, temporal tendinitis, thyroid and cricoid cartilage syndromes, and mastoid process syndrome are summarized.

An Interesting Case of Nuchal Rigidity

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.

3 Cases of Acute Retropharyngeal Calcific Tendinitis Misconceived as Acute Retropharyngeal Abscess

Acute retropharyngeal calcific tendinitis or calcific tendinitis of the longus is an under-rec ognized clinical syndrome first described by Hartley in 1964. This syndrome is caused by calcium hydroxylapatate deposition in the longus colli muscle and tendon. Patients typically present with acute neck pain, neck spasm, a restrained range of motion, odynophagia, dysphagia and sore throat. Clinically, it can be misconceived as acute retropharyngeal abscess because of its rather non-specific presentation and rare occurrence. Diagnosis of retropha ryngeal calcific tendinitis can be made radiographically with plain radiograph and CT by de tecting calcifications anterior to C1-C3 and swelling prevertebral soft tissue. Recognizing this radiologic imaging findings and features can prevent unnecessary treatment and test. We report three patients with acute prevertebral calcific tendinitis, which was misdiagnosed as acute retropharyngeal abscess.� Korean J Otorhinolaryngol-Head Neck Surg 2011;54:411-4

Acute Retropharyngeal Calcific Tendinitis in an Unusual Location: a Case Report in a Patient with Rheumatoid Arthritis and Atlantoaxial Subluxation

Acute Retropharyngeal Calcific Tendinitis in an Unusual Location: a Case Report in a Patient with Rheumatoid Arthritis and Atlantoaxial Subluxation

Acute retropharyngeal calcific tendinitis: a case report with unusual location of calcification

Retropharyngeal calcific tendinitis is an inflammatory process caused by calcium hydroxyapatite crystal deposition in the longus colli tendon of the prevertebral space, and it may mimic a retropharyngeal infection or abscess. The diagnosis of retropharyngeal calcific tendinitis will be made radiologically by the detection of calcifications anterior to C1-C3 and prevertebral soft tissue swelling. We present a case of acute retropharyngeal calcific tendinitis with an unusual location of calcification anterior to the C5-C6 disc.

A Severe Sore Throat in a Middle-Aged Man: Calcific Tendonitis of the Longus Colli Tendon

Neck pain is a common presentation to the Emergency Department (ED), requiring appropriate evaluation to exclude serious pathology. To review an atypical clinical presentation of neck pain and to distinguish this case and its associated radiographic features from more common clinical entities. We present an ED case of calcific tendonitis of the longus coli muscle. Acute calcific retropharyngeal tendinitis is a rare, benign etiology of non-traumatic neck pain that is poorly recognized and often mistaken for other conditions secondary to infection or trauma. The importance of this disorder, as well as a review of the literature on the subject, is presented.

Acute calcific tendinitis of the longus colli: an imaging diagnosis

Acute calcific retropharyngeal tendinitis or longus colli tendinitis is an uncommon benign condition presenting as acute neck pain. Clinically, it can be misdiagnosed as retropharyngeal abscess, traumatic injury, or infectious spondylitis. The diagnosis is made radiographically by calcification anterior to C1-C2 and prevertebral soft-tissue swelling. We present two cases of this uncommon condition to illustrate the classic findings on CT and MRI. In addition to the typical calcifications anterior to C1-C2, we detected a retropharyngeal effusion in both patients and effusions involving both lateral atlantoaxial joints in one patient, which to our knowledge has not been published in the literature. In both patients, the correct diagnosis was established by prospective review of the radiographic studies. Recognition of the pathognomonic imaging appearance allows for easy diagnosis preventing unnecessary tests and treatment.

Calcific retropharyngeal tendinitis: a frequently missed diagnosis

✓Neck pain is a common presentation in emergency departments that requires the exclusion of serious underlying pathological entities. Acute calcific retropharyngeal tendinitis is a rare and underrecognized cause of atraumatic neck pain and stiffness. Although this entity has been reported previously, it is often poorly recognized and is often confused with other more serious lesions, such as infectious, traumatic, and neoplastic conditions. Clinically, it can be very difficult to distinguish from these three disorders, and a definitive diagnosis can only be established using imaging studies. A knowledge of the characteristic clinical spectrum and, most importantly, its imaging features is crucial for making the correct diagnosis of this uncommon cause of neck pain. The authors present their experience with one case to highlight the characteristic findings of this disorder on plain radiography, computed tomography, and magnetic resonance imaging.

Calcific retropharyngeal tendinitis: a frequently missed diagnosis

Neck pain is a common presentation in emergency departments that requires the exclusion of serious underlying pathological entities. Acute calcific retropharyngeal tendinitis is a rare and underrecognized cause of atraumatic neck pain and stiffness. Although this entity has been reported previously, it is often poorly recognized and is often confused with other more serious lesions, such as infectious, traumatic, and neoplastic conditions. Clinically, it can be very difficult to distinguish from these three disorders, and a definitive diagnosis can only be established using imaging studies. A knowledge of the characteristic clinical spectrum and, most importantly, its imaging features is crucial for making the correct diagnosis of this uncommon cause of neck pain. The authors present their experience with one case to highlight the characteristic findings of this disorder on plain radiography, computed tomography, and magnetic resonance imaging.

Acute calcific retropharyngeal tendinitis. Clinical presentation and pathological characterization.

Acute calcific retropharyngeal tendinitis is an underrecognized cause of pain and stiffness in the neck associated with odynophagia and retropharyngeal soft-tissue swelling. We report on five patients in whom an initial misdiagnosis of this entity as a retropharyngeal or nasopharyngeal abscess, a neoplasm, or a fracture-dislocation of the cervical spine led to interventions such as admission to the hospital and parenteral administration of antibiotics. An open biopsy was performed in one patient because of a suspected neoplasm. Evaluation of the tissue specimen with routine and polarized light microscopy, scanning electron microscopy, and energy-dispersive spectrometry demonstrated a foreign-body inflammatory response to deposited crystals of hydroxyapatite. In all five patients, the correct diagnosis was established only after retrospective review of the radiographic studies by a physician who was familiar with acute calcific retropharyngeal tendinitis. The computed tomographic findings of acute calcific retropharyngeal tendinitis are distinctive and consist of prevertebral calcification localized to the insertion of an edematous tendon of the longus colli muscle. Symptomatic relief was provided with anti-inflammatory and analgesic medications. The symptoms resolved, without sequelae, within one to two weeks for all of the patients. We hope that an increased awareness of hydroxyapatite deposition in the tendon of the longus colli muscle will result in improved early diagnosis of acute calcific retropharyngeal tendinitis.

Retropharyngeal calcific tendinitis: Report of five cases and review of the literature

Retropharyngeal calcific tendinitis is an inflammation of the longus colli muscle tendon, which is located on the anterior surface of the vertebral column extending from the atlas to the third thoracic vertebra. Five cases of acute retropharyngeal calcific tendinitis seen in the emergency department (ED) over a 15-month period are reported. In addition, a retrospective review of four cases diagnosed as retropharyngeal abscess and admitted to the hospital revealed that two of these cases actually represented retropharyngeal calcific tendinitis. A review of the literature and potential differential diagnoses are presented. For those primary care physicians who must evaluate patients with acute cervical pain, sore throat, or odynophagia, an x-ray study of the neck revealing retropharyngeal calcium deposition should raise the question of the diagnosis of acute retropharyngeal tendinitis. Clinical characteristics of this entity include a painful condition which is treatable and is often mistaken for retropharyngeal abscess, pharyngitis, or peritonsillar abscess. In our opinion, this condition may be more prevalent than the literature suggests.