A 54-year-old male patient complained of recent acute onset of severe neck pain and stiffness. MR revealed a retropharyngeal effusion and edematous infiltration of the longus colli (Figure 1). Radiographs and CT demonstrated calcifications anterior to C1-C2 (Figure 2). The patient shortly recovered after treatment with corticosteroids.
Figure 1
(A) MR exhibits typical findings of acute calcific prevertebral tendinitis. T1-enhanced and (B and C) T2-weighted images demonstrate enhancement and edematous infiltration of the prevertebral soft tissues anterior to C1-C2, as well as a retropharyngeal effusion extending from C2 to C6 (arrowheads); and (D) A focus of gadolinium-enhancement is depicted in the left superior oblique fibers on the longus colli muscle (arrow).
(A) MR exhibits typical findings of acute calcific prevertebral tendinitis. T1-enhanced and (B and C) T2-weighted images demonstrate enhancement and edematous infiltration of the prevertebral soft tissues anterior to C1-C2, as well as a retropharyngeal effusion extending from C2 to C6 (arrowheads); and (D) A focus of gadolinium-enhancement is depicted in the left superior oblique fibers on the longus colli muscle (arrow).
Figure 2
(A) Lateral radiography and (B and C) reformatted CT demonstrate an amorphous calcification (arrows) beneath the anterior arch of C1 and a slight intra-osseous migration with cortical erosion in the anterior margin of C2; (D) Note effacement of the prevertebral tissues, as well as a retropharyngeal effusion (arrowhead); and (E) A 3D bone reconstruction exhibits the pathognomonic calcification (arrow).
(A) Lateral radiography and (B and C) reformatted CT demonstrate an amorphous calcification (arrows) beneath the anterior arch of C1 and a slight intra-osseous migration with cortical erosion in the anterior margin of C2; (D) Note effacement of the prevertebral tissues, as well as a retropharyngeal effusion (arrowhead); and (E) A 3D bone reconstruction exhibits the pathognomonic calcification (arrow).
Tendinitis of the longus colli, also known as retropharyngeal tendinitis, is a rare nonsurgical condition caused by intratendinous deposition of hydroxyapatite calcium1,2,3. Although CT may easily depict the pathognomonic calcification, it is important to recognize this benign disease with MR, because this is frequently becoming the first imaging modality for suspected spinal disease3,4,5.
References
- 1 Bladt O, Vanhoenacker P, Bevernage C, Van Orshoven M, Van Hoe L, D'Haenens P. Acute calcific prevertebral tendinitis. JBR-BTR. 2008;91:158-9.
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2 esmots F, Derkenne R, Couppey N, Martin B, Gabaudan C, Geffroy Y. Calcific retropharyngeal tendinitis of the longus colli muscle. Diagn Interv Imaging. 2013;94(3):470-3. http://dx.doi.org/10.1016/j.diii.2012.09.006
» https://doi.org/10.1016/j.diii.2012.09.006 - 3 Eastwood JD, Hudgins PA, Malone D. Retropharyngeal effusion in acute calcific prevertebral tendinitis: diagnosis with CT and MR imaging. AJNR Am J Neuroradiol. 1998;19(9):1789-92.
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4 Mihmanli I, Karaarslan E, Kanberoglu K. Inflammation of vertebral bone associated with acute calcific tendinitis of the longus colli muscle. J Neuroradiology. 2001;43(12):1098-101. http://dx.doi.org/10.1007/s002340100644
» https://doi.org/10.1007/s002340100644 -
5 Roldan CJ, Carlson PJ. Longus colli tendonitis, clinical consequences of a misdiagnosis. AM J Emer Med 2013;31(10):1538.e1-2. http://dx.doi.org/10.1016/j.ajem.2013.05.035
» https://doi.org/10.1016/j.ajem.2013.05.035
Publication Dates
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Publication in this collection
Jan 2015
History
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Received
06 Aug 2014 -
Reviewed
09 Sept 2014 -
Accepted
29 Sept 2014