Clin Orthop Surg.  2018 Jun;10(2):204-209. 10.4055/cios.2018.10.2.204.

Clinical and Imaging Features of Longus Colli Calcific Tendinitis: An Analysis of Ten Cases

• Suh B
• Eoh J
• Shin J

• KMID: 2411746
• DOI: http://doi.org/10.4055/cios.2018.10.2.204

Abstract

BACKGROUND
Longus colli calcific tendinitis (LCCT) exhibits characteristic clinical features; thus, misidentification can be avoided once it is learned. There is a lack of reports on this disease. In this study, we analyzed the imaging and clinical features of LCCT in 10 patients.
METHODS
We retrospectively reviewed the radiolographic findings, laboratory data and clinical features of 10 patients diagnosed with LCCT between January 2015 and June 2017. All patients were treated with medical treatment consisting of intravenous methylprednisolone 125 mg twice and oral nonsteroidal anti-inflammatory drug administration.
RESULTS
On clinical findings, all 10 patients complained of severe posterior neck pain and cervical motion limitation. Odynophagia was present in nine patients. The mean time from symptom onset to hospital visit was 2.9 days. The mean time to symptom relief was 4.6 days. Of the 10 patients, three patients were admitted through the emergency room. There were five patients in the medical records who were transferred from another hospital. On the laboratory data, the mean value of C-reactive protein and erythrocyte sedimentation rate were 2.08 mg/dL (reference range, < 0.30 mg/dL) and 36.9 mm/hr (reference range, < 20 mm/hr), respectively. Leukocytosis was found in only two patients and fever was not present all patients. On radiographic findings, calcification was present on computed tomography images of all patients. The calcification was located at the lower part of the C1 arch, except for one case where calcification occurred in the anterolateral aspect of the C4-5 disc space. The mean value of the retropharyngeal space was 7.2 mm.
CONCLUSIONS
LCCT, a rare disease, has characteristic radiographic findings and clinical features. Understanding such characteristics of this disease can prevent unnecessary testing and misdiagnosis.

Keyword

Longus colli muscle; Calcific tendinitis; Odynophagia

MeSH Terms

Blood Sedimentation
C-Reactive Protein
Diagnostic Errors
Emergency Service, Hospital
Fever
Humans
Leukocytosis
Medical Records
Methylprednisolone
Neck Pain
Rare Diseases
Retrospective Studies
Tendinopathy*
C-Reactive Protein
Methylprednisolone

Figure

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  Fig. 1 The graph shows an analysis of the symptoms of 10 cases.

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  Fig. 2 The pie chart shows the route of patient admission (A) and whether they had visited other hospitals (B).

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  Fig. 3 Calcification was not seen in simple radiography (A), but computed tomography showed calcification (arrows) under the C1 arch (B, C).

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  Fig. 4 Calcification was located under the C1 arch in computed tomography in nine cases (A, B), and retropharyngeal swelling and effusion were shown (C). In one case, calcification was located on the left side of the longus colli muscle at the C4–5 level (D–F).

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