Acute Prevertebral Calcific Tendinitis: A Nonsurgical Cause of Prevertebral Fluid Collection

Abstract

Calcific tendinitis of the preve rtebral muscles is a rare clinical entity. Its nonspecific presenting symp toms (e.g., retrop haryngeal space inf ection) may mimic an inf ectious etiology. Treatment is based on the administration of a nonsteroidal anti-infla mmatory drug (NSAID) for 2 to 3 weeks and cessation of symptom-provo king activity. Most patients will improve greatly within the fi rst 48 to 72 hours aft er the initiation of an NSAID, and complete resolution generally occurs within 3 weeks. We describe a new case ofprevertebral calcific tendinitis, and we review the literature on this condition.

A Severe Sore Throat in a Middle-Aged Man: Calcific Tendonitis of the Longus Colli Tendon

“…The pathogenesis of crystal deposition remains unclear, though chronic trauma, inflammation, recent injury, tissue degeneration, and ischemia have been suggested as possible etiologies (2,13,15). Of note, a metabolic abnormality of calcium or phosphate does not seem related (11,18).…”

“…Of note, a metabolic abnormality of calcium or phosphate does not seem related (11,18). The tendons of the shoulder and hip are most often affected by calcification, but this process can occur in any tendon near an articulation (4,7,9,15). Acute symptoms occur when crystal deposits within the tendon, which are initially contained, rupture and initiate a painful secondary inflammatory response (17).…”

Retropharyngeal Calcific Tendonitis Mimics a Retropharyngeal Abscess

“…Both of our patients showed significant improvement with NSAIDs, although they were also initially treated with a limited course of antibiotics which was likely excessive [6]. Importantly, the otolaryngologist should review the CT with the radiologist as the radiologist often has limited clinical information about the patient.…”

Prevertebral tendinitis: How to avoid unnecessary surgical interventions

“…The totally different therapy regimens for both pathologic entities, however, make a clear and expeditious diagnostic pathway indispensable, especially with regard to unnecessary surgical intervention. Because of its paucity and the obvious difficulty of correct diagnostic pathways, the literature about PT is poor and contains predominantly case reports6–12; a prospective study is still missing. Since Hartley's3 and Weinberg and Scott's4 articles in the 1960s and 1980s, the possibilities in radiologic imaging have changed fundamentally and opened different diagnostic pathways 5, 13, 15, 17–21…”

“…Acute calcific tendinitis of the longus colli muscle is a rare, self‐limiting, inflammatory disease, which was first described by Hartley3 in 1964, redefined by Weinberg and Scott4 in 1982, and is currently known under a number of synonyms, such as prevertebral or retropharyngeal tendinitis 5–20. The underlying pathophysiological reason is a calcium hydroxyapatite deposition in the longus colli tendon assumed to induce acute inflammation of the longus colli muscle tendon insertion 3.…”