The authors have no funding, financial relationships, or conflicts of interest to disclose.
Head and Neck
Prevertebral tendinitis: How to avoid unnecessary surgical interventions†
Article first published online: 1 MAY 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 7, pages 1570–1574, July 2012
How to Cite
Hammer, G. P., Vollmann, R., Tomazic, P. V., Simbrunner, J. and Friedrich, G. (2012), Prevertebral tendinitis: How to avoid unnecessary surgical interventions. The Laryngoscope, 122: 1570–1574. doi: 10.1002/lary.23338
- Issue published online: 21 JUN 2012
- Article first published online: 1 MAY 2012
- Accepted manuscript online: 5 APR 2012 04:57AM EST
- Manuscript Accepted: 12 MAR 2012
- Manuscript Revised: 6 MAR 2012
- Manuscript Received: 6 FEB 2012
- Head and neck;
- prevertebral tendinitis;
- retropharyngeal abscess;
- benign prevertebral effusion;
- magnetic resonance imaging;
- computed tomography;
- Level of Evidence: 4
Prevertebral tendinitis is an inflammatory process that affects the cervicothoracic prevertebral muscles. Because of its clinical presentation and imaging features in computed tomography scans, prevertebral tendinitis can easily be mistaken for deep cervical abscess formation. Totally different therapy regimens require clinical and diagnostic pathways for sufficient differentiation between those two pathologic entities.
Case series with comparison.
In 10 patients with prevertebral tendinitis, we evaluated the symptoms, laboratory reports, and radiological imaging findings. We compared these data to 65 patients with a deep cervical abscess formation. The basic radiologic imaging procedure was contrast-enhanced computed tomography. For detection of prevertebral tendinitis, we performed magnetic resonance imaging with diffusion-weighted images and calculated the apparent diffusion coefficient map.
Patients with prevertebral tendinitis complained of severe neck pain, globus sensation, and neck stiffness. Diffusion-weighted images showed a typical benign prevertebral effusion. Computed tomography scans showed amorphous calcifications in the tendon of the prevertebral muscles. The C-reactive protein values were slightly increased in patients with prevertebral tendinitis, and white blood cell count remained normal. In comparison to patients with deep cervical abscess formation, the C-reactive protein and white blood cell count was significantly lower (P < .05) in the prevertebral tendinitis cases.
Prevertebral tendinitis should be considered when patients suffer from neck pain, neck stiffness, and globus sensations despite low signs of inflammation in the laboratory report. To confirm the diagnosis, the best imaging feature is magnetic resonance imaging with diffusion-weighted images and apparent diffusion coefficient map. Laryngoscope, 2012