The Journal of Bone and Joint Surgery, Vol 76, Issue 11 1636-1642, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Acute calcific retropharyngeal tendinitis. Clinical presentation and pathological characterization
D Ring, AR Vaccaro, G Scuderi, MN Pathria and SR Garfin
University of California at San Diego.
Acute calcific retropharyngeal tendinitis is an underrecognized cause of
pain and stiffness in the neck associated with odynophagia and
retropharyngeal soft-tissue swelling. We report on five patients in whom an
initial misdiagnosis of this entity as a retropharyngeal or nasopharyngeal
abscess, a neoplasm, or a fracture-dislocation of the cervical spine led to
interventions such as admission to the hospital and parenteral
administration of antibiotics. An open biopsy was performed in one patient
because of a suspected neoplasm. Evaluation of the tissue specimen with
routine and polarized light microscopy, scanning electron microscopy, and
energy-dispersive spectrometry demonstrated a foreign-body inflammatory
response to deposited crystals of hydroxyapatite. In all five patients, the
correct diagnosis was established only after retrospective review of the
radiographic studies by a physician who was familiar with acute calcific
retropharyngeal tendinitis. The computed tomographic findings of acute
calcific retropharyngeal tendinitis are distinctive and consist of
prevertebral calcification localized to the insertion of an edematous
tendon of the longus colli muscle. Symptomatic relief was provided with
anti-inflammatory and analgesic medications. The symptoms resolved, without
sequelae, within one to two weeks for all of the patients. We hope that an
increased awareness of hydroxyapatite deposition in the tendon of the
longus colli muscle will result in improved early diagnosis of acute
calcific retropharyngeal tendinitis.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
