# Longus colli calcific tendinitis, an uncommon cause of neck pain. A short series of cases and review of literature

## TL;DR

This paper presents five cases of longus colli calcific tendinitis, a rare cause of neck pain that can mimic more serious conditions and is often underdiagnosed.

## Contribution

The paper adds a short case series and highlights the importance of recognizing LCCT to avoid misdiagnosis and unnecessary treatments.

## Key findings

- LCCT presents with neck pain, stiffness, and sometimes odynophagia, but no fever or radiculopathy.
- CT and MRI confirmed calcific deposits and retropharyngeal edema in all five cases.
- LCCT is self-limiting and caused by a foreign-body reaction to calcium hydroxyapatite deposits.

## Abstract

Longus colli acute calcific tendinitis (LCCT) is a painful disease characterized by a triad of neck pain, neck stiffness and odynophagia. It is a relatively rare cause of neck pain, often unknown or underdiagnosed, but it is important to be aware of its existence as it can mimic other potentially more dangerous illnesses.

We present a short series of five cases in which we gathered demographic and clinical data including imaging studies and compared our findings to previous reports by other authors. The diagnosis of LCCT was made by the combination of a compatible clinical presentation and blood workup plus the identification of a calcific deposit in the proximal oblique fibers of the longus colli muscle and retropharyngeal edema via computed tomography.

Five patients were analyzed. Mean age was 44 years, three female and two male. All patients initially presented neck pain and painful mobilization, while only 60% presented with odynophagia. There were no patients with radiculopathy nor fever. The mean values for ESR, CRP and White Blood Cell (WBC) were 23.2 mm/h, 2.97 mg/dl and 10.21 * 10^9/L respectively. On CT and/or MRI exploration all the patients presented a visible calcific deposit on the anteroinferior border of the anterior C1 arch and visible signs of retropharyngeal oedema.

LCCT is a self-limited pathology that is caused by a foreign-body type reaction in the retropharyngeal space secondary to the degradation and resorption of calcium hydroxyapatite deposits usually found at the anteroinferior border of the anterior C1 arch. It is necessary to create awareness of this pathology amongst physicians because it can mimic more serious illness like retropharyngeal abscess, meningitis and spondylodiscitis and this may lead to unnecessary expenditures and antibiotic usage.