A 45-year-old man with subacute onset of neck pain...
A 45-year-old man with subacute onset of neck pain and stiffness with no history of trauma or fever
A
B
C
D
What is your diagnosis?
The answer is Longus Colli Tendinitis
Longus colli tendinitis is an inflammatory response to deposition of hydroxyapatite crystals in the superior oblique tendons of the longus colli muscle, which lies anterior to the thoracic and cervical vertebral bodies.
It originates at the transverse processes of C5 to T3 and inserts at the anterior arch of the atlas.
Presentation varies from mild subacute neck pain and stiffness to acute and debilitating neck pain and motion limitation with odynophagia or dysphagia.
Imaging features include prevertebral soft tissue edema (arrows in A–C) from C1 to C4.
Amorphous calcific deposits are usually seen inferior to the anterior arch of the atlas (arrow in D) and help clinch the diagnosis.
Treatment is usually conservative.
中文版：
男性，45歲，頸部疼痛、僵硬，亞急性起病，既往無外傷史，無發(fā)熱。
診斷：頸長(zhǎng)肌肌腱炎
頸長(zhǎng)肌肌腱炎是因羥磷灰石晶體沉積于頸長(zhǎng)肌的上斜肌肌腱引起的炎性反應(yīng)，該肌腱位于頸胸部椎體的前方。
它起自C5-T3椎體的橫突，止于寰椎前弓。
臨床表現(xiàn)：從輕度亞急性頸部疼痛、僵硬，至急性、嚴(yán)重頸部疼痛以及活動(dòng)受限，可合并吞咽疼痛或吞咽困難。
影像表現(xiàn)為C1-C4椎體前方軟組織腫脹（A-C圖箭頭）。
寰椎前弓下方可見不規(guī)則鈣鹽沉積（D圖箭頭），該征象有助于臨床診斷。
治療方式為保守治療。
From AJNR Classic Case
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