Ben Soh Chin, Lim Kai Xiong
Internal Medicine Department, Changi General Hospital, Singapore.
Internal Medicine Department, Sengkang General Hospital, Singapore.
Eur J Case Rep Intern Med. 2025 Apr 2;12(4):005278. doi: 10.12890/2025_005278. eCollection 2025.
Acute calcific tendinitis of the longus colli muscle can present with symptoms resembling severe conditions such as meningitis, an intracranial abscess, a retropharyngeal abscess or cervical spondylodiscitis.
A 37-year-old Chinese female was admitted with neck pain, headache, fever and odynophagia, raising concerns for meningitis, a retropharyngeal abscess or cervical spondylodiscitis. The physical examination was unremarkable except for restricted neck movement and tenderness over right upper paravertebral area. Laboratory investigations were unremarkable. A CT scan of the neck showed nodular calcification just below the C1 anterior arch; MRI with contrast revealed T2-weighted hyperintensity with enhancement in the retropharyngeal space, along with minor oedema over the adjacent longus coli muscle. A final diagnosis of acute calcific tendinitis of longus colli was established, based on the radiological findings and clinical response to treatment.
Acute calcific tendinitis of the longus muscle is a rare inflammatory condition caused by the deposition of amorphous calcium hydroxyapatite crystals in the anterior C1-C2 disc space. Due to its anatomical location, inflammation will result in triggering similar symptoms as in meningitis, an intracranial abscess, a retropharyngeal abscess or cervical spondylodiscitis. CT and MRI imaging are the gold standard for diagnostic investigation; there are no formal treatment guidelines, and management is conservative, primarily involving analgesia.
Clinicians should be aware that acute calcific tendinitis of the longus muscle can present with symptoms that mimic other severe conditions such as meningitis, an intracranial abscess, a retropharyngeal abscess or cervical spondylodiscitis.
Be aware of the presentation of acute calcific tendinitis of the longus colli muscle, which can mimic severe conditions such as meningitis, an intracranial abscess, a retropharyngeal abscess or cervical spondylodiscitis.Recognising the characteristic radiological findings of acute calcific tendinitis of the longus colli muscle is crucial to avoid unnecessary invasive and surgical interventions and ensure appropriate conservative management.
颈长肌急性钙化性肌腱炎的症状可能类似于脑膜炎、颅内脓肿、咽后脓肿或颈椎间盘炎等严重疾病。
一名37岁中国女性因颈部疼痛、头痛、发热和吞咽痛入院，引发了对脑膜炎、咽后脓肿或颈椎间盘炎的担忧。体格检查除颈部活动受限和右上椎旁区域压痛外无异常。实验室检查无异常。颈部CT扫描显示C1前弓下方有结节状钙化；增强MRI显示咽后间隙T2加权高信号并强化，相邻颈长肌有轻微水肿。根据影像学表现和治疗的临床反应，最终确诊为颈长肌急性钙化性肌腱炎。
颈长肌急性钙化性肌腱炎是一种罕见的炎症性疾病，由无定形羟基磷灰石晶体沉积于C1-C2前间隙引起。由于其解剖位置，炎症会导致引发与脑膜炎、颅内脓肿、咽后脓肿或颈椎间盘炎相似的症状。CT和MRI成像是诊断检查的金标准；目前尚无正式的治疗指南，治疗以保守为主，主要是止痛。
临床医生应意识到颈长肌急性钙化性肌腱炎可能表现出类似脑膜炎、颅内脓肿、咽后脓肿或颈椎间盘炎等其他严重疾病的症状。
了解颈长肌急性钙化性肌腱炎的表现，其可模仿脑膜炎、颅内脓肿、咽后脓肿或颈椎间盘炎等严重疾病。认识颈长肌急性钙化性肌腱炎的特征性影像学表现对于避免不必要的侵入性和手术干预以及确保适当的保守治疗至关重要。
