Blake S Raggio1, Samuel C Ficenec2, Jason Pou1, Brian Moore3,4. 1. Department of Otolaryngology, Tulane University Medical Center, New Orleans, LA. 2. Tulane University School of Medicine, New Orleans, LA. 3. Department of Otolaryngology, Ochsner Clinic Foundation, New Orleans, LA. 4. The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
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.
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.