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Clinical Problem Solving: Radiology
June 2012

Radiology Quiz Case 2: Diagnosis

Arch Otolaryngol Head Neck Surg. 2012;138(6):600. doi:10.1001/archoto.2012.519b

Originally described by Hartley1 in 1964, acute calcific tendinitis of the longus colli is a benign, uncommon, and often underrecognized cause of acute neck pain due to calcium hydroxyapatite deposition in the tendon of the longus colli, with reactive inflammation of the longus colli muscle.1,2 The peak incidence occurs in patients aged between 30 and 60 years but has been reported within an age range of 21 to 81 years.3 It more commonly occurs in other areas of the body, such as the hips or shoulders (eg, calcific tendenitis of the supraspinatus tendon).4 The etiology of calcium hydroxyapatite deposition remains unclear, but it has been suggested that injury or ischemia may be involved. The foreign body–like inflammatory reaction, potentially caused by rupture of calcific crystals, may result in edema or fluid collection within the retropharyngeal or prevertebral space surrounding the muscle.2,4