Three cases of retropharyngeal calcific tendonitis: A rare and treatable cause of acute neck pain.

Abstract

Learning objectives: To identify retropharyngeal calcific tendonitis (RCT) as a differential diagnosis in the clinical presentation of acute neck pain, and recognise its radiographic signs in plain film, CT and MRI. Background: This slide show presents three cases of RCT which presented to Nambour emergency department with undifferentiated neck pain. RCT is an inflammatory reaction to the deposition of hydroxyapatite crystals within the tendon of longus colli. The primary presenting complaint is acute neck pain made worse by movement, however occipital pain, muscular spasms of the neck, odynophagia, dysphasia, and fever have also been described. The symptoms can be relatively nonspecific and thereby being able to recognise the imaging findings of RCT helps to elicit the cause of the patient's neck pain, preventing further unnecessary investigations and procedures. Imaging findings OR procedure details: We will present the plain film, CT and MRI findings of RCT from our 3 patients which include: prevertebral soft tissue swelling and oedema, amorphous calcification anterior to C1/C2 and the absence of an enhancing collection in the retropharyngeal space. Conclusion: RCT of the longus coli muscle is a benign treatable condition with similar presenting complaints to the more serious diagnosis of a retropharyngeal abscess. Early recognition of this entity prevents incorrect treatment and unnecessary hospital admission as well as providing early relief to the patient with simple anti-inflammatory treatment.<br />