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Case Reports in Otolaryngology
Volume 2014, Article ID 286190, 4 pages
http://dx.doi.org/10.1155/2014/286190
Case Report

Calcific Tendonitis of the Longus Colli Muscle: A Noninfectious Cause of Retropharyngeal Fluid Collection

Division of Otolaryngology, Head & Neck Surgery, University of British Columbia, Gordon & Leslie Diamond Health Care Centre, 4th Floor, 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9

Received 26 August 2014; Accepted 12 November 2014; Published 24 November 2014

Academic Editor: Wolfgang Issing

Copyright © 2014 Ronak Rahmanian and Chris Diamond. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Calcific tendonitis of the longus colli (CTLC) muscle is an underrecognized cause of spontaneous acute or subacute neck pain, dysphagia, or odynophagia. Imaging may reveal a retropharyngeal fluid collection leading to the presumed diagnosis of retropharyngeal abscess. Recognition of this uncommon presentation is important to prevent unnecessary surgical incision and drainage. A 44-year-old otherwise healthy male presented with a 2-week history of progressive neck pain, stiffness, and odynophagia. A noncontrast CT scan of the cervical spine revealed a retropharyngeal fluid collection with a small area of calcification anterior to C2. There was a presumed diagnosis of retropharyngeal abscess. The patient was afebrile with normal vital signs. Flexible nasolaryngoscopy was unremarkable. C-reactive protein was elevated but all other bloodwork was normal with no evidence of an infective process. A CT scan was repeated with IV contrast showing no enhancement around the fluid collection. A diagnosis of CTLC was made. The patient was successfully managed with a short course of intravenous steroids and oral NSAIDs with complete resolution of symptoms. Clinically CTLC can mimic more serious disease processes. Identifying pathognomonic imaging findings often confirms the diagnosis. Awareness of this condition by the otolaryngologist will ensure proper patient management and avoidance of unnecessary procedures.