[clickpenguin_460]

It wasn’t calcific tendinitis of longus colli?
 
[link=https://radiopaedia.org/articles/calcific-tendinitis-of-the-longus-colli-muscle-2?lang=us]https://radiopaedia.org/a…colli-muscle-2?lang=us[/link]

[Unknown Member]

LOL. The ENT brought that up. No calcification so less likely.

[Unknown Member]

I’ve seen the same findings on MRI. 
I think its related to the above/hydroxyapatite more than we know. They have neck pain, but no signs of infection. I always check for calcification if there is a ct; but mostly negative; still I bet there are plenty of cases without CA++. 

[stlmchenry_510]

I think so too

[samsone_882]

Yes, seen prob 8-10 cases like this, some without and some with mild leukocytosis. Half in peds, half in young adults.

I prob learned the concept of it incorrectly, saw my first few cases clustered together in residency and in my kind equated it on the spectrum of the step before retropharyngeal abscess

Maybe seen it with more frequency because our ED non-physician providers and some docs will CT anyone with a pulse / sore throat? Other than the young age, Ive never associated it with another demographic factor or association, usually just young people with sore throat / URI and difficulty swallowing

[samsone_882]

**in my mind – my mobile browser (and more likely technical ineptness) isnt letting me edit the above

[Unknown Member]

Quote from Rad1Brad

Yes, seen prob 8-10 cases like this, some without and some with mild leukocytosis. Half in peds, half in young adults.

I prob learned the concept of it incorrectly, saw my first few cases clustered together in residency and in my mind equated it on the spectrum of the step before retropharyngeal abscess

Forme fruste of retropharyngeal abscess? How were they managed? Antibiotics with close follow up? Did any progress to abscess?

[Unknown Member]

As above, I’ve seen it in adults with neck pain.
We are talking minimal fluid/edema.
No signs of infection. but definite pain.
Normal C spine o/w.
Could it be forme fruste of retropharyngeal abscess; of course.
But I don’t think so; I believe inflammatory, but not infectious, and think more in the line of mild or early hydroxyapatite dz.
Who knows, but I have not seen it develop into something bad.
Just my anecdotal experience.
 

[samsone_882]

For follow-up — most were just discharged from the ED never to be heard of again. One or two had ENT consult, follow-up, and follow-up imaging pursued and it went away. All had antibiotics for management, not quite sure if it’s a prelude to a retropharyngeal abscess. No c-spine issues in the ones I’ve seen. Maybe something in the water where I practice, ha 

[msc5405]

Serositis from something like lupus? SVC syndrome?

[Unknown Member]

Great discussion

[aaco]

volume overload
 
 

[Unknown Member]

Quote from MODIOLUS

volume overload

I see volume overload all the time. It is diffuse, not local or isolated to the retropharyngeal space.
 
I thought about isolated angioedema but no epiglottic, aryepiglottic fold or uvular edema so unlikely.

[seb_arrosa_904]

don’t forget normal variants like maga epiglotis etc among  many other normal or borderline variants in addition to very  common artifact from dental hardware which can make  Ct neck reading exceedingly  difficult

[Unknown Member]

Saw a retropharyngeal hemangioma once. Rad called retropharyngeal abscess. ENT loved that one.