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Clinical Note |

Acute Calcific Longus Colli Tendinitis An Unusual Location and Presentation

Alexander S. Boikov, BA; Brent Griffith, MD; Matthew Stemer, MD; Rajan Jain, MD
Arch Otolaryngol Head Neck Surg. 2012;138(7):676-679. doi:10.1001/archoto.2012.910.
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Acute calcific longus colli tendinitis (LCT) has been reported as an unusual cause of acute-onset neck pain, dysphagia, and headache.15 As described in most of the published reports, LCT traditionally manifests on computed tomography (CT) imaging as paramidline calcium hydroxyapatite crystal deposits anterior to the C1 and C2 vertebral bodies. However, recent studies have brought attention to the disease existing at the C4-C5 and C5-C6 levels.6,7 Acute LCT is considered relatively benign, typically resolving on its own within several weeks.

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Figure 1. Lateral radiograph of the neck showing widening of the prevertebral soft tissues and calcifications anterior to C4 and C5 (arrows).

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Figure 2. Computed tomographic (CT) images of our case patient. A, Reformatted sagittal CT image showing dystrophic calcifications anterior to the C4 and C5 vertebral bodies (arrows). B, Absence of calcifications in a similar image taken 4 years earlier. C, Axial image showing the paramidline dystrophic calcification anterior to the C5 vertebral body (arrow) along with glottic narrowing. D, Axial image showing the paramidline dystrophic calcification anterior to the C4 vertebral body (arrow) as well as marked prevertebral soft-tissue swelling.

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Figure 3. Diagrammatic representation of the longus colli muscle and its tendons. Black circles represent calcifications in the vertical portions of the longus colli muscle opposite C4 and C5. (This drawing was created originally to illustrate the present article but was inspired by the 2011 article by Lee et al.6)

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