Acute Non-calcific Tendonitis of the Longus Colli: An Uncommon and Underrecognized Cause of Neck Pain.

Introduction: Acute non-traumatic neck pain is a highly prevalent condition with diverse and multifaceted etiologies. Longus colli calcific tendinitis is an uncommon yet important cause of acute inflammatory neck pain in middle-aged adults. Case report: A 51-year-old female presented with a 3-day history of acute neck pain, which showed poor response to oral medication. The patient was admitted with acute neck pain and showed an inadequate response to initial symptomatic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs). Following repeated intermittent glucocorticoid therapy, the patient ^, s pain was found to be exquisitely responsive to steroids. Upon careful review and discussion of the Magnetic Resonance Imaging (MRI) scans, a prevertebral fluid collection was identified that had been initially overlooked. No significant prevertebral calcification was detected on cervical computed tomography(CT), and the final diagnosis was non-calcific tendinitis of the longus colli muscle. The patient improved significantly following continuous corticosteroid therapy and was discharged. Conclusion: Acute non-calcific tendinitis of the longus colli is an extremely rare cause of acute neck pain, and is highly prone to being missed or misdiagnosed, particularly in patients presenting with isolated neck pain without odynophagia. In patients with acute severe neck pain, MRI evaluation is essential, requiring careful evaluation of not only intraspinal pathologies but also the thickness and signal intensity of the prevertebral fascia.