A 36-year-old woman presented with sudden, severe neck pain and odynophagia. On examination, she was alert and afebrile with marked nuchal rigidity and tenderness to palpation over the posterior neck. Pharyngoscopy was normal. MRI showed calcification of the C1 to C2 longus coli tendon and prevertebral fluid from C1 to C4 (figure,A).
Figure MRIs
T2-weighted MRI (A) revealed abnormal thickening and hypointensity of the longus colli tendon anterior to C1 and C2 (arrow) consistent with calcification. There was an associated prevertebral fluid collection extending from C1 to C4 (arrowhead). These findings were consistent with calcific retropharyngeal tendinitis. Follow-up T2-weighted MRI (B) showed resolution of the above changes.
Calcific retropharyngeal tendonitis1,2 causes acute or subacute neck pain that can be mistaken for more ominous diagnoses such as cervical spine fracture, retropharyngeal abscess, meningitis, or neoplasm. It is typically self-limited, resolving over days to weeks (figure, B).
This patient received steroids and analgesics, and her symptoms resolved by day 8.
Footnotes
-
Disclosure: The authors report no disclosures.
Disputes & Debates: Rapid online correspondence
NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.
- Stay timely. Submit only on articles published within the last 8 weeks.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- 200 words maximum.
- 5 references maximum. Reference 1 must be the article on which you are commenting.
- 5 authors maximum. Exception: replies can include all original authors of the article.
- Submitted comments are subject to editing and editor review prior to posting.