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The Journal of the American Board of Family Medicine 22 (1): 84-88 (2009)
DOI: 10.3122/jabfm.2009.01.080034
© 2009 American Board of Family Medicine
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Brief Report

Retropharyngeal Calcific Tendonitis: Report of Two Cases

Rhea Victoria B. Razon, MD, Asad Nasir, MD, George S. Wu, MD, Manal Soliman, MD and Jeffrey Trilling, MD

Departments of Family Medicine (RVBR, MS, JT), Stony Brook University Hospital, New York
Internal Medicine (AN), Stony Brook University Hospital, New York
Radiology (GSW), Stony Brook University Hospital, New York

Correspondence: Corresponding author: Rhea Victoria B. Razon, MD, Department of Family Medicine, Stony Brook Hospital, Nicholls Road, Level 4, Stony Brook, New York 11794 (E-mail: rheavictoria{at}yahoo.com)

Retropharyngeal calcific tendonitis is an inflammatory process of the superior oblique tendons of the longus colli muscle, a neck flexor in the upper cervical spine, caused by deposition of calcium hydroxyapatite crystals; the definitive diagnostic test is computed tomography (CT). Presented in this article are two cases seen at our institution. Patients typically present with acute onset of neck pain/spasm, odynophagia, dysphagia, and/or low grade fevers. Leukocytosis and elevated erythrocyte sedimentation rate may be noted. It is important to understand this entity because its signs and symptoms are mimickers of those of the more serious condition of retropharyngeal space abscess. Calcific tendonitis is managed conservatively whereas retropharyngeal abscess requires incision and drainage. Some may argue that this entity is a zebra because its reported incidence in the literature is low. However, most of these studies were done in an era when CT was not yet in vogue. With today's widespread use of CT and its superb ability to visualize the calcification, the true incidence of this condition is probably higher and, thus, it is important for the family practitioner to be aware of this entity. The astute clinician may save the patient from unnecessary diagnostic workup, undue anxiety, and delays in hospital discharge.


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