第4-5頸椎に石灰化を認めた石灰沈着性頸長筋腱炎の2例

抄録

Calcific tendinitis of the longus colli muscle is an inflammation of the longus colli muscle characterized by the acute onset of neck pain, swallowing pain, and limitations of neck movement. Rapid development of symptoms requires careful differential diagnosis from conditions such as retropharyngeal abscess.

We report two cases of calcific tendinitis of the longus colli muscle with an unusual location of the calcification. Both patients were referred to our hospital by an orthopedist, with the complaints of odynophagia, neck pain and limitations of neck movement. Contrast-enhanced computed tomography revealed calcifications anterior to the C4-C5 vertebral bodies and a low-density area without ring enhancement in the retropharyngeal space. We made the diagnosis of calcific tendinitis of the longus colli muscle and treated the patient conservatively.

It is not yet an adequately recognized disease among otolaryngologists. We reviewed 32 reported cases by otolaryngologists. The patients consisted of 18 men (56%) and 14 women (44%). The median age was 41 years (25–70 years old). Of the 32 patients, 17 cases (53%) were diagnosed as having calcific tendinitis of the longus colli muscle, 11 (34%) as having a retropharyngeal abscess; of the latter, 7 cases were treated by incision or puncture and drainage. In all 32 cases (100%), the calcifications were anterior to the C1-C2 vertebral bodies. The clinical presentations in our cases were similar to these reported cases. Careful differentiation is important to determine the appropriate treatment.