Acute Calcific Tendinitis of the Longus Colli: Not All Retropharyngeal Fluid is an Abscess

This report aimed to present a case of acute calcific tendinitis of the longus colli muscle as an uncommon cause of neck pain and dysphagia and is often misdiagnosed as a retropharyngeal abscess.

Case report and literature review.

Acute calcific tendinitis is often misdiagnosed as a retropharyngeal abscess; however, it is distinguished from the latter based on patient history and unique radiologic findings. History, examination, and laboratory findings do not suggest an infectious etiology, and radiographic findings include a non-rim-enhancing fluid collection with or without calcifications anterior to the upper cervical spine.

Unlike retropharyngeal abscess, acute calcific tendinitis is managed conservatively. When consulted for a possible retropharyngeal abscess, the otolaryngologist should avoid anchoring bias by independently obtaining a detailed history and examination and personally reviewing radiologic images to avoid unnecessary intervention.