Disclosures: Benjamin J. Burnham, DO: No financial relationships or conflicts of interest

Case Diagnosis: 52 year old man with acute calcific tendinitis of the longus colli muscle

Case Description: The patient presented with a 48 hour history of acute, progressive, left sided neck pain with decreased range of motion (ROM) and odynophagia. He denied recent infections or trauma. Physical exam revealed diminished cervical flexion, extension, and rotation and no lymphadenopathy, uvular deviation, or oropharyngeal erythema. Laboratory data revealed a leukocytosis of 12,400 white blood cells per microliter. He was admitted under observation and computerized tomography (CT) with contrast was obtained to rule out retropharyngeal abscess.

Setting: Tertiary care hospitalAssessment/

Results: CT findings revealed calcification of the longus colli muscle anterior to the odontoid process and non-rim-enhancing retropharyngeal fluid collections, consistent with acute calcific tendinitis of the longus colli muscle. He was briefly treated with ketorolac and dexamethasone and discharged with prednisone and ibuprofen. Upon follow up, he reported resolution of pain and normalization of ROM.

Discussion: Calcific tendinitis of the longus colli muscle is a rare cause of cervical pain resulting from deposition of calcium hydroxyapatite crystals in the tendons of the longus colli muscle. It typically presents with neck pain, dysphagia, odynophagia, fever, and diminished cervical ROM. Because of the presentation, it can be concerning for more severe cases like retropharyngeal abscess. It can be diagnosed via CT imaging revealing soft tissue calcification anterior to C1-C2. Treatment is managed conservatively with non-steroidal anti-inflammatory drugs and/or corticosteroids.

Conclusion: Calcific tendinitis of the longus colli muscle is a rare pathology important to consider on the differential for acute neck pain. It can present similar to more severe conditions, though with proper imaging, it is easily diagnosed and treated with conservative management.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/acute-calcific-tendinitis-of-the-longus-colli-muscle-a-case-report/