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A Case of Longus Colli Muscle Tendinitis

In this case report, doctors from Madrid, Spain review the clinical picture and diagnosis of a condition called calcific retropharyngeal tendinitis. This problem is caused by calcium deposits that build up in the longus colli muscle of the anterior neck.

When these deposits rupture, the patient experiences neck pain, sore throat, and difficulty swallowing. Upper neck pain and stiffness can be severe. There may be tenderness and swelling along the front of the neck. The cause of this problem remains unknown. There may be genetic and metabolic factors. Trauma and tendon degeneration may be risk factors.

Diagnosis can be made on the basis of the patient's symptoms and imaging studies. X-rays may show calcification within the tendon where it attaches to the bone. CT scans are more sensitive than X-rays to show the exact location of the calcium deposits. MRI can help identify the cause of swelling (infection versus inflammation).

Treatment with an antiinflammatory drug helps reduce fever, swelling, pain, and stiffness. In this case, the patient was first treated with aspirin and muscle relaxants. The symptoms did not improve and he got worse. He was switched to a nonsteroidal antiinflammatory drug (Indomethacin) and was symptom-free within a two-week period of time. Follow-up a year later with CT scan and MRI showed the calcification was completely gone.

The authors conclude that although uncommon, calcific retropharyngeal tendinitis occurs more often than previously thought. They suggest the condition is an underdiagnosed cause of neck pain and stiffness. Anyone with neck pain, limited motion, and difficulty swallowing without a known cause should be examined for this condition.

References: Sara Jiménez, MD, and José M. Millán, MD. Calcific Retropharygeal Tendinitis: A Frequently Missed Diagnosis. Case Report. In Journal of Neurosurgery: Spine. January 2007. Vol. 6. No. 1. Pp. 77-80.

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