Calcific tendinitis of the longus colli muscle
Calcific tendinitis of the longus colli muscle is an inflammatory/granulomatous response to deposition of calcium hydroxyapatite crystals in the tendons of the longus colli muscle.
Patients can present with debilitating symptoms that are unrelated to the degree of calcification seen on CT.
Radiographic features
Plain film and CT
Calcifications may be seen on radiographs, but the preferred imaging modality is contrast-enhanced CT. On CT, amorphous calcifications are seen in the superior fibers of the longus colli muscle tendons (at the C1–C2 level). Small retropharyngeal effusions and edema of the adjacent prevertebral soft tissues may also be seen. Enhancement around the effusion should shift the diagnosis towards an abscess. Adenopathy and bone destruction, likewise, should suggest alternative diagnoses.
MRI
MRI will show the oedema, but is not as great with the calcifications. At least one case of localized marrow signal inflammatory has been reported.
Treatment
Conservative management with NSAIDs is generally all that is required. Symptoms tend to resolve within a few weeks.
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