Acute longus colli calcific tendinitis

Excerpt

A 50-year-old female with a 5-year history of well-controlled seropositive rheumatoid arthritis on methotrexate 15 mg weekly presented to the emergency department with a 3-day history of right-sided retropharyngeal and neck “knifelike” pain when swallowing. Labs including a complete blood count and inflammatory markers were unremarkable. She underwent a computed tomography (CT) scan of the neck (Fig. 1A, C) showing a prevertebral fluid collection from C1 to C6 with calcification just anterior to the dens and inferior to the anterior ring of C1, corresponding to the proximal longus colli tendon insertion. Due to concern for an abscess, the patient underwent a magnetic resonance imaging (MRI) scan (Fig. 1B) showing significant prevertebral edema in the right longus colli and longus capitis muscles. She responded within 24 hours to 10 mg dexamethasone and was discharged on a 10-day prednisone taper with complete resolution and without recurrence.

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