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Case No. 750
2026-04-01~2026-04-30
출제자 : 임영희
Hit : 405
| Period | 2026-04-01~2026-04-30 |
|---|---|
| Diagnosis | Calcific tendinitis of the longus colli muscles |
| Gender |
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| Age | 48 |
| Clinical information | 48/M C.C> Neck pain What is the diagnosis? |
| Discussion | <그림 설명> CT ; Diffuse fluid collection along retropharyngeal spaces. Dystrophic calcification at longus colli tendon at C1-2 level. MRI ; Increased signal and enhancement of longus coli tendon at clivus level~T5 level <해설> Calcific tendinitis of the longus colli muscle is a rare, benign, self-limiting inflammatory condition caused by deposition of calcium hydroxyapatite crystals in the tendon fibers of the longus colli muscle, typically at the superior oblique fibers (C1–C2 level). Pathophysiology; foreign-body inflammatory reaction to hydroxyapatite crystal deposition. Clinical findings 1. Acute neck pain 2. Neck stiffness 3. Odynophagia (painful swallowing) Dysphagia, limited ROM Low-grade fever Headache Imaging Findings CT 1.Amorphous calcifications anterior to C1–C2 2.Prevertebral/retropharyngeal edema or effusion 3.No rim enhancement (differential with abscess) MRI 1.Edema and inflammatory changes 2.Retropharyngeal fluid without enhancement Simple Radiography 1.Prevertebral soft tissue swelling 2.Possible calcifications at C1–C2 Differential Diagnosis Retropharyngeal abscess (enhancing collection, systemic toxicity) Infectious spondylitis or meningitis Disc herniation or trauma Management Conservative treatment No surgery or antibiotics unless misdiagnosed Reference; Qureshi P, et al. Acute calcific tendinitis of the longus colli muscle: case report and review of literature. Cureus. 2022;14(6):e25833. Reitz I, et al. Acute calcific tendinitis of the longus colli: an important differential diagnosis for neck pain. Am J Emerg Med. 2023. |
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