A Case of Retropharyngeal Calcific Tendinitis in a Patient with Ankylosing Spondylitis

Hyae Jin Yoon; Changnam Son; Seunghun Lee; Kungbin Joo; Tae Hwan Kim

doi:10.4078/jrd.2013.20.6.385

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Yoon, Son, Lee, Joo, and Kim: A Case of Retropharyngeal Calcific Tendinitis in a Patient with Ankylosing Spondylitis

Case Report

J Rheum Dis 2013;20(6):385-388.

Published online: 31 December 2013

DOI: https://doi.org/10.4078/jrd.2013.20.6.385

A Case of Retropharyngeal Calcific Tendinitis in a Patient with Ankylosing Spondylitis

Hyae Jin Yoon¹, Changnam Son^1,², Seunghun Lee³, Kungbin Joo³, Tae Hwan Kim^1,²

¹Department of Internal Medicine, Hanyang University Collegy of Medicine, Seoul, Korea

²Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea

³Department of Radiology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea

Corresponding to : Tae Hwan Kim, Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 222, Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea. E-mail : thkim@hanyang.ac.kr

Received 26 October 201212 March 2013 Accepted 22 March 2013

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Retropharyngeal calcific tendinitis, also known as calcific tendinitis of the longus colli muscle, was first described by Hartley in 1964. It is caused by deposition of calcium hydroxyapatite crystals in the longus colli muscles from C1 to C3. Retropharyngeal calcific tendinitis is diagnosed ra-diologically by the detection of amorphous calcification and prevertebral soft tissue swelling. Twelve cases of retro-pharnygeal calcific tendinitis have been reported in the Korean literature, but no cases with ankylosing spondylitis. In this case, we report an unusual case of retropharyngeal calcific tendinitis with ankylosing spondylitis.

Keywords: Neck pain, Ankylosing spondylitis

References

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Figure 1.

Plain radiograph reveals prevertebral calcification (arrow).

Figure 2.

(A) Sagittal non-enhan-ced CT of the neck and (B) axial images show amorphous calcific lesion (arrow) anterior to C1∼2.

Figure 3.

(A) MRI T2 sagittal image shows prominent swelling (arrow) of left side longus colli muscle insertion near the anterior arch of atlas with possible calcific tendinitis involving the longus colli muscles. (B) MRI T2 axial image shows low signal intensity (arrow) in the anterolateral space of the vertebra.

Table 1.

Summary of patients with retropharyngeal calcific tendinitisin in Korea

Patient no.	Age/Sex	Symptoms	Location of calcification	Treatment	Underlying disease	Reference no.
1	41/M	Neck pain, odynophagia, LOM	C1-2	Hydration, Antibiotics, NSAIDs		7
2	36/M	Neck pain, stiffness	C1-2	NSAIDs, muscle relaxant		8
3	45/M	Neck pain, stiffness, headache	C1-2	NSAIDs, analgesics		8
4	41/F	Neck pain, odynophagia	C5-6	NSAIDs, analgesics, antibiotics		9
5	48/F	Neck pain, odynophagia	C1	NSAIDs	Rheumatic arthritis	10
6	22/F	Odynophagia, stiffness	C1-2	NSAIDs		11
7	51/M	Neck pain, stiffness	C1	NSAIDs		11
8	48/F	Neck pain, stiffness, odynophagia	C1	NSAIDs	Rheumatic arthritis	12
9	83/F	Odynophagia, dysphagia	C5-6	NSAIDs, analgesics, antibiotics	Hypertension, DM, stroke, thyroid nodule	13
10	47/F	Stiffness	C1	Conservative		13
11	34/F	Neck pain, odynophagia	C1	Conservative		13
12	30/F	Neck pain, odynophagia	C4-5	NSAIDs	Rheumatic arthritis	14

LOM: limit of motion, DM: diabetes mellitus, NSAIDs: nonsteroidal antiinflammatory drugs.

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