Acute Calcific Prevertebral Tendonitis: an Uncommon Cause of Acute Neck Pain Presenting with a Retropharyngeal Effusion

FNY Sin, AB Lo, KL Siu, WP Chu

Hong Kong J Radiol 2011;14:89-92

Acute calcific prevertebral tendonitis is a self-limiting inflammatory process due to deposition of calcium hydroxyapatite in the tendon fibres of the longus colli muscles. Its initial clinical and radiological presentation significantly overlaps with that of a retropharyngeal abscess. In both conditions, patients may present with acute/subacute-onset neck pain, painful swallowing, fever and the appearance of retropharyngeal soft tissue thickening on the lateral neck radiograph due to presence of fluid. Definitive imaging diagnosis relies on the detection of prevertebral soft tissue calcification within the tendinous insertion of the longus colli muscle at about the C1-2 level. It is important for radiologists and clinicians to be aware of this condition and its imaging findings in order to differentiate it from retropharyngeal infection, so as to avoid misdirected medical therapy and invasive attempts at surgical drainage.

中文摘要

急性鈣化性椎前肌腱炎：急性頸痛伴咽後積液的一個罕見病因

單雅怡、羅彪、蕭廣樂、朱惠邦

急性鈣化性椎前肌腱炎是一種自限性炎症過程，病因為羥磷灰石鈣物質積聚在頸長肌的腱纖維內。 起初的臨床及放射表徵與咽後膿腫相類似，兩種病的患者均會有急性或亞急性頸痛、吞嚥時感到痛 楚、發燒，並由於積液的關係，咽後軟組織往往在放射影像中變厚。為病人確診，必須在C1-2椎骨 頸長肌腱的位置發現椎前軟組織鈣化。要避免誤用藥物治療及避免手術引流的侵入式治療，臨床醫 生及放射科醫生必須了解此病及放射影像表現以區別此病與咽後感染。