Korean J Pain.  2016 Jan;29(1):48-52. 10.3344/kjp.2016.29.1.48.

Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome

• Oh JY
• Lim JH
• Kim YS
• Kwon YE
• Yu JY
• Lee JH

• KMID: 2151660
• DOI: http://doi.org/10.3344/kjp.2016.29.1.48

Abstract

Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendinitis, who complained of posterior neck pain, initially diagnosed and treated as a myofascial neck pain syndrome.

Keyword

Differential diagnosis; Longus colli; Myofascial pain syndrome; Odynophagia; Posterior neck pain; Retropharyngeal calcific tendinitis

MeSH Terms

Deglutition Disorders
Diagnosis, Differential
Durapatite
Humans
Myofascial Pain Syndromes
Neck Pain*
Neck*
Physical Examination
Tendinopathy*
Durapatite

Figure

• 

  Fig. 1 Lateral view of the cervical plain radiograph showed a large area of prevertebral soft tissue swelling from C1 to C5 (white arrow) and focal calcifications anterior to the C1 and C2.

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  Fig. 2 Sagittal T2 weighted MR image shows the high signal retropharyngeal effusion with acute inferior margin extending from the skull base to the inferior border of C5 (white arrow).

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  Fig. 3 Bone sagittal view of contrast-enhanced computed tomography shows retropharyngeal fluid collection and three calcific deposits anterior to the C1-C2 level (white arrow).

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  Fig. 4 Nasopharyngolaryngoscopy shows posterior pharyngeal wall swelling overlying arytenoids (white arrow).

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  Fig. 5 Follow up lateral view of the cervical plain radiograph showed much improved prevertebral swelling.

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