Case report and literature review of a patient with recurrent contralateral retropharyngeal tendinitis

Introduction:

Retropharyngeal tendinitis is a rare disease and is usually not recognized directly. Pathophysiologically, inflammation of the M. longus colli is caused by deposition of calcium crystals. The mostly self-limiting disease heals faster under NSAIDs and steroids. We report the rare case of a delayed contralateral retropharyngeal tendinitis (RT) and summarize the current literature.

Material and Methods:

Retrospective evaluation of a patient with RT and the current literature on PubMed search in the years 2008 – 17.

Results:

A 50-year-old male was reffered with neck stiffness, odynophagia, and occipital cephalgia for the past 3 days. Two years earlier, the patient presented himself with the same symptoms, but contralateraly, he was treated with antibiotics and NSAIDs for several weeks with a suspected diagnosis of pharyngitis. The ENT findings were inconspicuous, CRP 2 mg/dl (norm < 0.5), WBC in normal range. In the native neck CT scan, calcifications were described on the left M. longus colli. Retrospectively, a calcification of the right M. longus colli could be detected on the CT in 2015. With the current diagnosis of RT, therapy with prednisolone and ibuprofen was prescribed. Within two days, the patient was symptom free. 10 evaluable case reports were found in PubMed. All described odynophagia and calcification of the M. longus colli on CT and 9 out of 10 referred neck stiffness. The time to diagnosis varied (1 to 20 days).

Discussion:

RT is often misdiagnosed because of its similarity in symptoms with retropharyngeal and neck abscesses or meningitis. At the above mentioned symptoms and a delayed course of the disease, a CT scan should be ordered to make the diagnosis.

Publication History

Publication Date:
18 April 2018 (online)