Age / Sex : 52 / F

Age / Sex :  52/F

Chief complaint : Neck Pain

What is your impression? 

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

(Please submit only one answer)

Courtesy : Eugene Lee, Seoul National University Bundang Hospital

Calcific Tendinitis of Longus Colli muscle

Discussion

Findings:

1)  C-spine Lateral view

    : C-spine
Lateral view showed diffuse pre-vertebral soft tissue thickening with focal
calcified lesion at anterior aspect of C2 (black arrow)

2)  MR – 1, 2, 3

: MRI sagittal scan with T1, T2 and
T1 fs enhanced images showed diffuse soft tissue swelling with enhancement at
C1~5 pre-vertebral space with irregular T1 and T2 low signal intensity lesion
at anterior aspect of C2. There was no remarkable bone marrow signal
abnormality at cervical spine.

Differential Diagnosis: none

Diagnosis:
Calcific Tendinitis of Longus Colli muscle

Discussion:

[Calcific Tendinitis of Longus Colli muscle]

: 
Acute inflammatory condition of the longus colli tendon, which is
related to calcium hydroxyapatite deposition in the superior oblique fibers of
the longus colli muscle.

Clinical
presentation

- 
acute onset of neck pain progressing over a period of several days

- 
neck stiffness with odynophagia and dysphagia

- 
low grade fever, leukocytosis

Plain
radiograph

•       Pre-vertebral swelling

•       Amorphous calcification anterior to
the C2 vertebral body

CT

•       Preferred imaging modality for
calcification

MRI

•       Inflammation involving and
surrounding the longus colli muscle.

Tx. :  conservative management.

References:

 The British Journal of Radiology
2009;82:117-121, Neurology 2011;76;e81