Acute Calcific Tendonitis of the Longus Colli: An Uncommon Cause of Neck Pain in the Emergency Department

Abstract

The longus colli muscle has three major parts that originate and insert in the upper cervical and thoracic spine. It is a weak flexor of the neck, and when contracted also serves to rotate the neck to the ipsilateral side. It is innervated by the anterior rami of the C2-C6 spinal nerves and receives its blood supply from the anterior cervical and inferior thyroid arteries. In a post motor vehicle collision (MVC) patients presenting weeks later, the physician has to ensure there is no subacute fracture. Clinically, these patients present with severe anterior neck pain that will often be described as a deep pain.

Calcific tendonitis of longus colli: a rare cause of neck pain

“…Treatment was with regular non-steroidal anti-inflammatory medication with proton pump cover and physiotherapy. Other published cases have described the use of steroids, H2 antagonists, surgical intervention and cervical collars1; however, there is little evidence to support their use.…”

Upper Thoracic Back Pain Due to Acute Calcific Tendinitis of the Longus Colli

“…In this case, calcification occurred at the attachment of the vertical or inferior oblique portion, causing thoracic back pain. Computed tomography is the gold standard for diagnosis (1,3). The differential diagnosis included retropharyngeal abscess, meningitis, crowned dens syndrome, and disc herniation.…”

“…The prognosis was good and, with the use of NSAIDs, symptoms improved within 3 weeks (1). If the symptoms are severe, glucocorticoid treatment is recommended (1)(2)(3). Awareness of this disease can help to avoid diagnostic errors.…”