Acute calcific longus colli tendonitis (ACLCT) is an inflammatory response of the prevertebral neck musculature due to pathognomonic calcium hydroxapatite deposition in the longus colli tendon at the vertebral body level of C1-C2.
MRI findings demonstrated a smooth retropharyngeal effusion extending from the skull base to the C5 level and asymmetric edema of the left longus colli muscle (Figure 2).
Acute calcific tendinitis of the longus colli muscle (CTLC) is a rare and self-limiting inflammatory disorder of the tendon insertions.
Ring et al reported a series of 5 cases in which patients initially received unnecessary medical treatments, including 1 case in which the patient underwent an open biopsy that suggested the histopathologic basis of this condition: a foreign-body inflammatory response to calcium hydroxyapatite deposition into the longus colli muscle.
Acute retropharyngeal tendinitis (calcific tendinitis of the longus colli), initially described by Hartley in 1964, is an acute inflammatory condition of the longus colli tendon.
The correct imaging diagnosis is based on (1) the presence of pathognomonic calcification in the superior tendon fibers of the longus colli muscle, (2) the presence of fluid within the retropharyngeal space without associated enhancement around the effusion, (3) the absence of inflammatory retropharyngeal lymph nodes, (4) the absence of any bony destruction of the adjacent cervical vertebrae, and (5) recognition of the variability in the degree of tendinous calcium deposition, which may range from subtle to the more typical marked globular amorphous appearance.
The mechanisms triggering haemorrhage into the retropharyngeal space are thought to be due to injury to the longus colli
muscles on the anterior surface of the vertebral bodies, the anterior longitudinal ligament or the anterior muscular and spinal branches of the vertebral artery (3).
Affected patients generally present with an inflammation of the longus colli muscle tendon.
hydroxyapatite crystals in the superior oblique tendon fibers of the longus colli muscle.
In addition, amorphous calcification was seen embedded within the superior oblique tendon (proximal tendon of the longus colli
muscle; Figure 2).
It had a smooth surface and was intimately involved in the fascial fibers of the paraspinal muscles, and it projected into the longus colli
A radiologic finding of an amorphous soft-tissue calcification in the longus colli
muscle at the level of C1 or C2 is considered pathognomonic for prevertebral calcific tendinitis.