Calcific Tendinitis of the Longus Colli

Sagittal-reformatted CT image shows calcification in the soft tissue anterior to C2 (arrow) and adjacent soft tissue swelling (arrowhead) in a patient presenting with acute non-traumatic neck pain.

Facts: Longus Colli

• Longus colli muscles, along with longus capitis are bilateral paired neck flexor that make up the prevertebral space.
• The superiormost fibers of the longus colli attach to the anterior tubercles of C1.
• See the anatomy of longus colli muscle

Facts: Calcific Tendinitis of Longus Colli

• Inflammatory condition due to deposition of calcium hydroxyapatite in the superior tendon fibers of the longus colli
• Uncommon disease, mostly seen between 30-60 years old
• Radiography and CT shows calcific (nonosseous) density in the prevertebral/retropharyngeal soft tissue anterior to C1-C2 WITH associated soft tissue swelling
• There may be fluid/effusion in the retropharyngeal space that can appear quite extensive
• Differentiation from retropharyngeal abscess/infection is important. In this disease, the fluid smoothly expands the retropharyngeal space, no enhancing wall, no associated suppurative lymph nodes and there is presence of calcification of the longus colli tendons.

Reference:

Eastwood JD, Hudgins PA, Malone D. Retropharyngeal effusion in acute calcific prevertebral tendinitis: diagnosis with CT and MR imaging. AJNR Am J Neuroradiol 1998;19:1789-1792.

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