scholarly journals Retropharyngeal tendinitis: Hydroxyapatite deposition driven headache and nuchal rigidity resolves with prednisone

2017 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Abhimanyu Amarnani ◽  
Yair Saperstein ◽  
Isabel M McFarlane ◽  
David J Ozeri
Keyword(s):  
Neck Pain ◽  
Clinical Work ◽  
Sudden Onset ◽  
Retropharyngeal Abscess ◽  
Retropharyngeal Space ◽  
Empirical Antibiotic Treatment ◽  
Nuchal Rigidity ◽  
Calcific Tendonitis ◽  
Retropharyngeal Tendinitis ◽  
Work Up

We present a case of a 42-year-old woman who presented with sudden onset severe headache, neck pain, and nuchal rigidity associated with dysphagia. The initial differential in this patient included meningitis or retropharyngeal abscess, and an extracranial neck CT showed an ill-defined hypo-attenuated lesion within the retropharyngeal space. However, the neck pain and dysphagia were unresponsive to empirical antibiotic treatment and pain management. Further CT with contrast identified acute calcific tendonitis of the longus colli tendon, also known as retropharyngeal tendonitis (RCT). Although RCT is already known as a rare, self-limiting inflammatory condition, we present a new case of RCT, with the uncommon features of headache and nuchal rigidity in an aseptic patient, while providing a diagnostic flow chart to guide the clinical work-up of similar presentations to also include RCT.

scholarly journals Acute Retropharyngeal Calcific Tendonitis as a Rare Cause of Odynophagia and Neck Pain

2021 ◽  
Author(s):  
Prempreet Kaur Manjit Singh ◽  
Muhammad Irsyad Mohamed Noor ◽  
Rohaizam Jaafar ◽  
Amali Ahmad ◽  
Irfan Mohamad
Keyword(s):  
Neck Pain ◽  
Calcium Hydroxyapatite ◽  
Sudden Onset ◽  
Retropharyngeal Space ◽  
Calcific Tendonitis ◽  
Longus Colli Muscle ◽  
Waking Up ◽  
Point Tenderness ◽  
Superior Oblique ◽  
Hydroxyapatite Crystals

Retropharyngeal calcific tendonitis (RCT) is an aseptic inflammatory process of the superior oblique tendons of the longus colli muscle caused by the deposition of calcium hydroxyapatite crystals. We reported a 23-year-old woman who presented with a sudden onset of neck pain with odynophagia after waking up from sleep. Physical examination showed paracervical point tenderness with limited neck movement in all directions. Prior to surgery, further imaging was requested to aid in diagnosis, which in turn revealed RCT. It is important to be aware that RCT presentation may mimic other severe conditions such as retropharyngeal space abscess or meningitis.

scholarly journals Calcific retropharyngeal tendinitis: Unusual cause of acute neck pain with nuchal rigidity

Neurology ◽  
2008 ◽  
Vol 71 (10) ◽  
pp. 778-778 ◽  
Author(s):  
A. N. L. Hunderfund ◽  
C. E. Robertson ◽  
M. L. Bell ◽  
D. J. Busby ◽  
T. F. Koehler ◽  
...  
Keyword(s):  
Neck Pain ◽  
Nuchal Rigidity ◽  
Retropharyngeal Tendinitis ◽  
Acute Neck Pain

scholarly journals Retropharyngeal Calcific Tendonitis Mimics a Retropharyngeal Abscess

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Natasha Pollak ◽  
Sonya Wexler
Keyword(s):  
Case Reports ◽  
Treatment Options ◽  
Fluid Collection ◽  
Treatment Strategies ◽  
Retropharyngeal Abscess ◽  
Retropharyngeal Space ◽  
Appropriate Treatment ◽  
Calcific Tendonitis ◽  
Limiting Condition ◽  
Operative Drainage

Retropharyngeal calcific tendonitis (RCT) is an uncommon, self-limiting condition that is often omitted in the differential diagnosis of a retropharyngeal fluid collection. This condition mimics a retropharyngeal abscess and should be considered when evaluating a fluid collection in the retropharyngeal space. Although calcific tendonitis at other sites has been well described in the medical literature, it appears that this entity has been underreported in the otolaryngology literature where only a few case reports have been identified. Presumably, the actual incidence is higher than the reported incidence, due to lack of familiarity with this disorder. As an otolaryngologist’s scope of practice includes the managements of retropharyngeal lesions, it is important for the otolaryngologist to recognize the presentation of acute RCT and be familiar with appropriate treatment strategies. Retropharyngeal calcific tendonitis presents with neck pain, limitation of neck range of motion and includes inflammation, calcifications, and a sterile effusion within the longus colli muscle. Treatment is medical with nonsteroidal anti-inflammatory medications. RCT does not require surgical treatment, and an accurate diagnosis can prevent unnecessary attempts at operative drainage. In this study, we discuss two cases of RCT, summarize the salient features in diagnosis, including key radiologic features, discuss treatment options, and review the literature.

scholarly journals Acute descending necrotizing mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes

2020 ◽  
Author(s):  
Ilijaz Pilav ◽  
Orhan Čustović ◽  
Arijana Horman-Leventa ◽  
Alma Alihodžić-Pašalić ◽  
Safet Mušanović ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Severe Form ◽  
Primary Site ◽  
Retropharyngeal Abscess ◽  
Retropharyngeal Space ◽  
Descending Necrotizing Mediastinitis ◽  
Prompt Treatment ◽  
Empirical Antibiotic Treatment ◽  
Clinical Center ◽  
Life Threatening

Descending necrotizing mediastinitis (DNM) is a rare, life-threatening form of mediastinitis caused by odontogenic, pharyngeal, or cervical infections. The retropharyngeal space is the most common primary site of infection. Given the fulminant course and high mortality rate, early diagnosis and prompt treatment are important predictors of survival in patients with DNM. Appropriate empirical antibiotic treatment, prompt surgical intervention, and proper management of patients in the intensive care unit can be of vital importance. We present the case of a previously healthy 20-year-old male patient who was successfully cured and discharged from the Clinical Center University of Sarajevo after suffering from a severe form of mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes.

scholarly journals Calcific Tendonitis of the Longus Colli Muscle: A Noninfectious Cause of Retropharyngeal Fluid Collection

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Ronak Rahmanian ◽  
Chris Diamond
Keyword(s):  
Neck Pain ◽  
Ct Scan ◽  
Fluid Collection ◽  
Vital Signs ◽  
Retropharyngeal Abscess ◽  
Uncommon Presentation ◽  
Longus Colli ◽  
Calcific Tendonitis ◽  
Serious Disease ◽  
Intravenous Steroids

Calcific tendonitis of the longus colli (CTLC) muscle is an underrecognized cause of spontaneous acute or subacute neck pain, dysphagia, or odynophagia. Imaging may reveal a retropharyngeal fluid collection leading to the presumed diagnosis of retropharyngeal abscess. Recognition of this uncommon presentation is important to prevent unnecessary surgical incision and drainage. A 44-year-old otherwise healthy male presented with a 2-week history of progressive neck pain, stiffness, and odynophagia. A noncontrast CT scan of the cervical spine revealed a retropharyngeal fluid collection with a small area of calcification anterior to C2. There was a presumed diagnosis of retropharyngeal abscess. The patient was afebrile with normal vital signs. Flexible nasolaryngoscopy was unremarkable. C-reactive protein was elevated but all other bloodwork was normal with no evidence of an infective process. A CT scan was repeated with IV contrast showing no enhancement around the fluid collection. A diagnosis of CTLC was made. The patient was successfully managed with a short course of intravenous steroids and oral NSAIDs with complete resolution of symptoms. Clinically CTLC can mimic more serious disease processes. Identifying pathognomonic imaging findings often confirms the diagnosis. Awareness of this condition by the otolaryngologist will ensure proper patient management and avoidance of unnecessary procedures.

A Case Study of a Large and Rare Pleomorphic Liposarcoma in The Chest Area

2020 ◽  
Author(s):  
Yuanjun Cheng
Keyword(s):  
Delayed Diagnosis ◽  
Clinical Work ◽  
Radical Excision ◽  
Pathological Findings ◽  
Chest Tightness ◽  
Pleomorphic Liposarcoma ◽  
Left Chest ◽  
Specific Symptoms ◽  
Work Up

Pleomorphic liposarcoma rarely develops in the chest area. This report presents a primary pleomorphic liposarcoma that was discovered in the left chest area of a 74-year-old female patient. The patient had presented specific symptoms, including cough, chest tightness and shortness of breath. A radical excision of the tumor was performed. The tumor was extremely large (27 cm - 24 cm- 10 cm) and completely encapsulated. Upon histological examination, it was diagnosed as a giant, pleomorphic liposarcoma. Thereafter, non-specific radiological and endoscopic results during clinical work-up delayed diagnosis until post-operative histology were gathered. In this report, the case-specific clinical and radiological diagnostic challenges are discussed, as well as the relevant surgical and pathological findings.

scholarly journals The Applications of Artificial Intelligence in Chest Imaging of COVID-19 Patients: A Literature Review

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1317
Author(s):  
Maria Elena Laino ◽  
Angela Ammirabile ◽  
Alessandro Posa ◽  
Pierandrea Cancian ◽  
Sherif Shalaby ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Literature Review ◽  
Diagnostic Imaging ◽  
Clinical Work ◽  
Rapid Expansion ◽  
Chest Imaging ◽  
Imaging Data ◽  
Prognostic Information ◽  
Quantitative Ct ◽  
Work Up

Diagnostic imaging is regarded as fundamental in the clinical work-up of patients with a suspected or confirmed COVID-19 infection. Recent progress has been made in diagnostic imaging with the integration of artificial intelligence (AI) and machine learning (ML) algorisms leading to an increase in the accuracy of exam interpretation and to the extraction of prognostic information useful in the decision-making process. Considering the ever expanding imaging data generated amid this pandemic, COVID-19 has catalyzed the rapid expansion in the application of AI to combat disease. In this context, many recent studies have explored the role of AI in each of the presumed applications for COVID-19 infection chest imaging, suggesting that implementing AI applications for chest imaging can be a great asset for fast and precise disease screening, identification and characterization. However, various biases should be overcome in the development of further ML-based algorithms to give them sufficient robustness and reproducibility for their integration into clinical practice. As a result, in this literature review, we will focus on the application of AI in chest imaging, in particular, deep learning, radiomics and advanced imaging as quantitative CT.

Neurofibromatosis type 1 with subarachnoid haemorrhage from the left vertebral arteriovenous fistula: case presentation and literature review

2021 ◽  
Vol 14 (2) ◽  
pp. e239880
Author(s):  
Toshinori Nishizawa ◽  
Takahiro Tsuchiya ◽  
Yoshihiro Terasawa ◽  
Yasuhiro Osugi
Keyword(s):  
Neck Pain ◽  
Subarachnoid Haemorrhage ◽  
Arteriovenous Fistula ◽  
Neurofibromatosis Type 1 ◽  
Epidural Haematoma ◽  
Neurofibromatosis Type ◽  
Sudden Onset ◽  
Vertebral Arteriovenous Fistula ◽  
First Case

We present the case of a 47-year-old woman with neurofibromatosis type 1 (NF1) with subarachnoid haemorrhage (SAH) from the left vertebral arteriovenous fistula, along with a review of previous cases. Our patient had a family history of NF1 and presented to the emergency department with a sudden-onset severe headache and neck pain. CT scan showed SAH. CT angiography revealed a left vertebral arteriovenous fistula and an epidural haematoma. She underwent direct surgery and was discharged without neurologic deficits. To our knowledge, this is the first case of SAH caused by perimedullary drainage of a vertebral arteriovenous fistula associated with NF1. In a literature search, we identified 40 cases of vertebral arteriovenous fistula associated with NF1. The majority of vertebral arteriovenous fistulas occurred on the left side and in women. Patients with vertebral arteriovenous fistula typically experience neck pain, radiculopathy, radiculomyelopathy and bruits.

scholarly journals Combinations of Symptoms in Emergency Presentations: Prevalence and Outcome

2019 ◽  
Vol 8 (3) ◽  
pp. 345 ◽  
Author(s):  
Tobias Kuster ◽  
Christian Nickel ◽  
Mirjam Jenny ◽  
Lana Blaschke ◽  
Roland Bingisser
Keyword(s):  
Time Course ◽  
Predictive Power ◽  
Secondary Analysis ◽  
Clinical Work ◽  
Adverse Outcomes ◽  
University Hospital ◽  
Chief Complaints ◽  
The University ◽  
Work Up ◽  
Inclusion Period

The predictive power of certain symptoms, such as dyspnoea, is well known. However, research is limited to the investigation of single chief complaints. This is in contrast to patients in the emergency department (ED) presenting usually more than one symptom. We aimed to identify the most common combinations of symptoms and to report their related outcomes: hospitalisation, admission to intensive care units, and mortality. This is a secondary analysis of a consecutive sample of all patients presenting to the ED of the University Hospital Basel over a total time course of 6 weeks. The presence of 35 predefined symptoms was systematically assessed upon presentation. A total of 3960 emergency patients (median age 51, 51.7% male) were included. Over 130 combinations of two, 80 combinations of three, and 10 combinations of four symptoms occurred 42 times or more during a total inclusion period of 42 days. Two combinations of two symptoms were predictive for in-hospital mortality: weakness and fatigue (Odds ratio (OR) = 2.45), and weakness and headache (OR = 3.01). Combinations of symptoms were frequent. Nonspecific complaints (NSCs), such as weakness and fatigue, are among the most frequently reported combinations of symptoms, and are associated with adverse outcomes. Systematically assessing symptoms may add valuable information for prognosis and may therefore influence triage, clinical work-up, and disposition.

scholarly journals Acute calcific retropharyngeal tendinitis: an unusual cause of neck pain

1984 ◽  
Vol 27 (6) ◽  
pp. 708-710 ◽  
Author(s):  
Jeff Sarkozi ◽  
Adel G. Fam
Keyword(s):  
Neck Pain ◽  
Retropharyngeal Tendinitis
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