Vol 32| Issue 1 | Jan – June 2019 | page: 2-6 | Tony Kavalakkatt, Ajith Thomas Abraham
Authors: Tony Kavalakkatt [¹], Ajith Thomas Abraham [¹]
 Department of Orthopaedics,
Baby Memorial Hospital, Calicut, Kerala, India.
Address of Correspondence
Dr. Tony Kavalakkatt,
Department of Orthopaedics, Baby Memorial
Hospital, Calicut, Kerala, India.
Introduction: Calcific tendinitis involves calcium deposition in the substance of the tendon at its insertion producing intolerable pain and other symptoms. Due to the odd presentation of symptoms, they are often mis-diagnosed or inappropriately treated. This phenomenon is most commonly seen affecting the shoulder region.
Calcific deposition occurring in the longus colli muscle is very rare and only a handful of cases has been reported in the orthopedic literature. The exact pathogenesis of this condition is still under debate. It is a self-limiting condition,
characterized by neck pain and restriction of neck movements with mild elevation of acute-phase reactants.
Study: We are reporting four cases of acute calcific tendinitis of longus colli muscle presented to our hospital with
progressive pain in the neck and restricted neck movements. Mean age group of the patients was between 50 and 75
years. Blood investigations were normal except for raised acute-phase reactants in two patients. Radiological evaluation showed increased soft tissue shadow in front of C1-C2 vertebra region anteriorly. Computed tomography (CT) of the cervical region was done without using contrast, which turns out to be beneficial in diagnosing all our cases. The axial sections of the CT scan showed the presence of calcific deposits at the insertion of superior oblique part of longus colli muscle. They were managed conservatively with anti-inflammatory medications and adequate rest. Remarkable recovery was noted within few days of treatment.
Conclusion: For any case with neck pain and limited neck motion, calcific tendinitis of longus colli muscle can be
thought as a differential diagnosis even though their presentation is very rare so as to avoid unnecessary interventions.
Keywords: Calcific tendinitis, longus colli muscle, Pre-vertebral shadow.
1. Oliva F, Via AG, Maffulli N. Physiopathology of intratendinous calcific deposition. BMC Med 2012;10:95.
2. Oliva F, Via AG, Maffulli N. Calcific tendinopathy of the rotator cuff tendons. Sports Med Arthrosc Rev 2011;19:237-43.
3. McCarty DJ Jr., Gatter RA. Recurrent acute inflammation associated with focal apatite crystal deposition. Arthritis
4. Harnier S, Kuhn J, Harzheim A, Bewermeyer H, Limmroth V. Retropharyngeal tendinitis: A rare differential diagnosis of severe headaches and neck pain. Headache 2008;48:158-61.
5. Ade S, Tunguturi T, Mitchell A. Acute calcific longus colli tendinitis: An underdiagnosed cause of neck pain and
dysphagia. Neurol Bull 2013;5:1-6.
6. Zibis AH, Giannis D, Malizos KN, Kitsioulis P, Arvanitis DL. Acute calcific tendinitis of the longus colli muscle: Case report and review of the literature. Eur Spine J 2013;22 Suppl 3:S434-8.
7. Offiah CE, Hall E. Acute calcific tendinitis of the longus colli muscle: Spectrum of CT appearances and anatomical
correlation. Br J Radiol 2009;82:e117-21.
8. Hartley J. Acute cervical pain associated with retropharyngeal calcium deposit. A case report. J Bone Joint Surg Am 1964;46:1753-4.
9. Ring D, Vaccaro AR, Scuderi G, Pathria MN, Garfin SR. Acute calcific retropharyngeal tendinitis. Clinical presentation and pathological characterization. J Bone Joint Surg Am 1994;76:1636-42.
10. Uhthoff HK, Loehr JW. Calcific tendinopathy of the rotator cuff: Pathogenesis, diagnosis, and management. J Am Acad Orthop Surg 1997;5:183-91.
11. Rui YF, Lui PP, Chan LS, Chan KM, Fu SC, Li G, et al. Does erroneous differentiation of tendon-derived stem cells. contribute to the pathogenesis of calcifying tendinopathy? Chin Med J (Engl) 2011;124:606-10.
12. Eastwood JD, Hudgins PA, Malone D. Retropharyngeal effusion in acute calcific prevertebral tendinitis: Diagnosis with CT and MR imaging. AJNR Am J Neuroradiol 1998;19:1789-92.
13. Rodrigue E, Costa JP. An Unusual cause of neck pain: Acute calcific tendinitis of the longus colli. J Med Cases 2014;5:171- 3.
14. Smith RV, Rinaldi J, Hood DR, Troost T. Hydroxyapatite deposition disease: An uncommon cause of acute
odynophagia. Otolaryngol Head Neck Surg 1996;114:321-3.
|How to Cite this Article: Kavalakkatt T, Abraham A T. Acute Calcific Tendinitis of Longus Colli, a Rare but
Masquerading Entity of the Neck: A Case Series Study and Brief Review. Kerala Journal of Orthopaedics Jan-June 2019; 32(1): 2-6 .