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Case of the Month – May 2018

By Dr Cameron Scott

History:

50 year old female with acute onset severe neck pain and difficulty swallowing.

Imaging:

Sagittal T2 fat sat and axial T2 sequences on MRI demonstrate fluid and oedema in the retropharyngeal soft tissues. In addition, there is low signal in the right longus colli muscle.

The axial CT confirms the presence of amorphous calcification in longus colli.

Diagnosis:

Calcific tendinitis of the longus colli muscle.

Discussion:

Calcific tendinitis of the longus colli muscle is an inflammatory response of the muscle in response to calcium hydroxyapatite crystal deposition.

Patients are typically young adult to middle age and present with neck pain, dysphagia and reduced neck movement. There may be fever and inflammatory markers can be elevated. Treatment is conservative and this condition is usually managed with Nonsteroidal anti-inflammatory drugs (NSAIDS).

Symptoms tend to resolve within 2-3 weeks.

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