Retropharyngeal Calcific Tendinitis Research Articles

Retropharyngeal calcific tendinitis-An underestimated cause of acute neck pain

Retropharyngeal calcific tendinitis is an aseptic inflammation of the longus cervicis muscle. This rare acute pain disorder of the neck region is aprognostically benign condition compared to neurological or otorhinolaryngological differential diagnoses. To capture the clinical appearance, diagnostics, treatment and course of this rare disease. In this retrospective monocentric observational study, demographic, clinical, paraclinical as well as treatment and follow-up data of all inpatients with adiagnosis of retropharyngeal calcific tendinitis admitted to the Diako Hospital Mannheim in the years 2018 to 2021 were analyzed. This study included four female and one male patient with an age between 36 years and 77years. Severe neck pain with restriction of cervical spine rotation was the leading clinical appearance, in four out of five patients there was apainful swallowing disorder. Inflammatory markers were elevated in four patients. Characteristic MRI or CT imaging alterations of the cervical spine confirmed the diagnosis. The symptoms resolved within 4-14days after treatment with nonsteroidal anti-inflammatory drugs (NSAID) and four patients additionally received glucocorticoids. No recurrences were observed during the follow-up period of 5-30months. The good prognosis of this rare disease is reflected by the rapid remission of symptoms under NSAIDs and glucocorticoids and by the absence of recurrences during follow-up. CT or MRI imaging is required to rule out differential diagnoses, and to confirm the characteristic imaging alterations of retropharyngeal calcific tendinitis. Additionally, cerebrospinal fluid puncture and otorhinolaryngological assessment may be necessary in some cases.

Retropharyngeal calcific tendinitis: A rare, benign, but painful condition with stiff neck.

A 51-year-old afebrile man visited the hospital with acute severe neck pain with stiff neck, but cervical CT showed no calcification around the odontoid process. Cervical MRI revealed prevertebral hyperintense area of edema at the C1-C5 vertebral bodies, providing the diagnosis of retropharyngeal calcific tendinitis. The patient was spared for lumbar puncture, and his symptoms swiftly disappeared only with oral NSAIDs.

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.

Prevalence and imaging characteristics of nasopharyngeal and eustachian tube tonsilloliths in 2244 patients determined using computed tomography

Nasopharyngeal tonsilloliths (NT) and eustachian tube tonsilloliths (ET) are not as well-known to radiologists as palatine and lingual tonsilloliths. The aim of this investigation was to determine the prevalence and imaging characteristics of NT and ET using CT and panoramic radiographs. We retrospectively assessed the scans of 2244 patients who underwent consecutive CT and panoramic radiographs of the maxillofacial region. The prevalence, size, number, and position of NT and ET were analysed. NT and ET were detected in 14 (0.6%) and 6 (0.3%) of 2244 patients on CT, respectively, but they were undetectable on panoramic radiographs. No significant difference was found in the prevalence with respect to sex. Although there was also no significant difference in the prevalence among age groups, tonsilloliths were most commonly noted in patients over 40 years old; they appeared as small and round calcified bodies, ranging from 1 to 3 mm in diameter. All NT were found 0 to 3 mm beneath the nasopharyngeal mucosal surface. The prevalence of NT and ET on CT was lower than that of palatine and lingual tonsilloliths. However, since they are encountered more frequently than clinically significant calcifying diseases such as retropharyngeal calcific tendinitis, clinicians should be able to correctly diagnose NT and ET based on their anatomical features.

Review Article: Retropharyngeal Abscess-Mimickers and Masqueraders.

To discuss a case of suspected retropharyngeal abscess having important clinical and academic significance. This paper discusses an unusual presentation and evolution of a well known condition such as retropharyngeal abscess. Though the diagnosis in this case was initially a retropharyngeal abscess, several unusual findings were evident, which interfered with the optimal management of the patient. A literature review revealed rare causes and lesions mimicking a retropharyngeal abscess, such as retropharyngeal calcific tendinitis and Kawasaki disease, which are neither familiar to otolaryngologists nor other specialists such as orthopedicians. It is possible that this patient was both over treated and undertreated at the same time. Though the diagnosis in this case could not be established with certainty, several important pieces of information came up, especially unusual causes of retropharyngeal abscess and management of the same. Retropharyngeal abscess is a well-known condition with established modes of management. However, certain variations may occur and may pose challenges in diagnosis and management. These variations are little known and need to be highlighted so that optimal management is ensured.

Retropharyngeal calcific tendinitis presenting with neck pain and severe dysphagia: A case report

AbstractWe herein describe a 45‐year‐old man with posterior neck pain and severe dysphagia secondary to retropharyngeal calcific tendinitis. Brain stem infarction as a result of vertebral artery dissection was suspected, but head magnetic resonance imaging showed no acute ischemic lesion. Sagittal T2‐weighted neck magnetic resonance imaging showed a retropharyngeal fluid collection from C2 to C8, and neck computed tomography showed calcification at the tendon of the longus colli muscle. Based on these characteristic imaging findings, retropharyngeal calcific tendinitis was diagnosed. Neurologists should remember that retropharyngeal calcific tendinitis can cause neck pain and severe dysphagia, and mimic brain stem infarction as a result of vertebral artery dissection.

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

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.

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.

Incidence of Retropharyngeal Calcific Tendinitis (Longus Colli Tendinitis) in the General Population

To determine the incidence of retropharyngeal calcific tendinitis (longus colli tendinitis) in a general urban adult population. Observational study in a municipal medical center. Single tertiary referral center. 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. 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. 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.

A Case of Calcific Retropharyngeal Tendinitis: The Significance of an Early Diagnosis

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.

Calcific retropharyngeal tendinitis of the longus colli muscle. Answer to the e-quid “Acute cervical pain and dysphagia in a 43 year-old man”

Calcific retropharyngeal tendinitis of the longus colli muscle. Answer to the e-quid “Acute cervical pain and dysphagia in a 43 year-old man”

A Case of Retropharyngeal Calcific Tendinitis in a Patient with Ankylosing Spondylitis

Retropharyngeal calcific tendinitis, also known as calcific tendinitis of the longus colli muscle, was first described by Hartley in 1964. It is caused by deposition of calcium hydroxyapatite crystals in the longus colli muscles from C1 to C3. Retropharyngeal calcific tendinitis is diagnosed radiologically by the detection of amorphous calcification and pre-vertebral soft tissue swelling. Twelve cases of retropharnygeal calcific tendinitis have been reported in the Korean literature, but no cases with ankylosing spondylitis. In this case, we report an unusual case of retropharyngeal calcific tendinitis with ankylosing spondylitis.

石灰沈着性頸長筋腱炎の8例

Calcific retropharyngeal tendinitis/retropharyngeal calcific tendinitis is an inflammation of the longus colli muscle caused by calcium hydroxyapatite crystal depositon in the longus colli muscle tendon. The three major symptoms are neck pain, limitations of neck movement, and swallowing pain. We treated 8 cases of calcific retropharyngeal tendinitis/ retropharyngeal calcific tendinitis. Each patient complained of neck pain, limitations of neck movement, and swallowing pain. The only local finding was the smooth swelling of the posterior pharyngeal wall. CT imaging showed calcification of the tendon of the longus colli muscle and a low density area in the retropharyngeal space without ring enhancement, suggesting a retropharyngeal abscess. MR imaging showed the smooth swelling of the retropharyngeal space and an increased signal intensity on T2-weighted MR imaging. Calcific retropharyngeal tendinitis heals spontaneously, and treatment is not usually required. However, the clinical outcomes are similar and can be confused with retropharyngeal abscess and pyogenic spondylitis, so antibiotics are administrated in many cases. In our report, 7 patients were hospitalized and were treated with the intravenous administration of antibiotics, while 1 patient who refused hospitalization was treated with an oral antibiotic. Steroids were administrated in 2 cases. The 7 patients who were hospitalized were cured within 6 to 10 days.

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.

Retropharyngeal calcific tendinitis—longus colli tendinitis—an unusual cause of acute dysphagia

Retropharyngeal calcific tendinitis is a rare but probably an underdiagnosed and an underestimated disease caused by calcium hydroxyapatite deposition in the longus colli tendon [1–3]. Acute or subacute inflammation of these calcifications may lead to a false diagnosis of retropharyngeal abscess or phlegmon because of the association of severe cervical pain, stiff neck, and dysphagia and with a possible mild elevation of white blood cell count and C-reactive protein. The correct diagnosis is made by the recognition of pathognomonic signs on plain film and CT. The evolution is spontaneously favorable under medical treatment associating antiinflammatory drugs and analgesics [4, 5].

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.