A rare cause of acute dysphagia: acute calcific tendonitis of the longus colli muscle

BMJ Case Rep. 2017 May 27:2017:bcr2017219684. doi: 10.1136/bcr-2017-219684.

Abstract

We are presenting a case of a 78-year-old female with multiple comorbidities and history of neck surgery, who presented with acute dysphagia, odynophagia and neck pain that has been progressively getting worse over the course of 2 days, with no recent injury or infection. The patient was afebrile. There were no visible signs of infection on routine oropharyngeal examination. Initial workup was unremarkable except for elevated erythrocyte sedimentation rate, C-reactive protein and creatinine. CT of the cervical spine ruled out any fracture or cervical spine injury but showed an area of calcification, prevertebral oedema and fluid collection inferior to the anterior arch of C1. MRI of the cervical spine also showed prevertebral oedema and fluid collection in the retropharyngeal space from the skull base to the C3 level without abnormal surrounding enhancement that supported the diagnosis of acute calcific tendonitis of the longus colli muscle rather than an infectious process. There was significant improvement of symptoms 48 hours after initiating treatment with systemic steroids. The patient remains asymptomatic 6 months after treatment.

Keywords: Gastroenterology; Infectious diseases; Musculoskeletal and joint disorders; Pain; Tendonopathies.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Calcinosis / diagnostic imaging
  • Calcinosis / drug therapy
  • Calcinosis / physiopathology
  • Deglutition Disorders / diagnostic imaging
  • Deglutition Disorders / etiology*
  • Diagnosis, Differential
  • Female
  • Humans
  • Neck Muscles / diagnostic imaging
  • Neck Muscles / pathology*
  • Neck Pain / diagnostic imaging
  • Neck Pain / drug therapy
  • Neck Pain / etiology
  • Prednisone / therapeutic use
  • Tendinopathy / complications*
  • Tendinopathy / diagnostic imaging
  • Tendinopathy / drug therapy
  • Tendinopathy / physiopathology
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Prednisone