Dento maxillo facial radiology · 2025
Clinical, CT, and MRI features of acute calcific tendinitis of the longus colli: a case series with novel imaging findings.
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Loureiro Rafael Maffei, Sumi Daniel Vaccaro, da Costa Vitória Liz Taumaturgo, Gomes Regina Lúcia Elia, Soares Carolina Ribeiro
Аннотация
OBJECTIVE: To evaluate the clinical and radiologic features of acute calcific tendinitis of the longus colli (ACTLC).
METHODS: This retrospective, cross-sectional study analysed 30 patients diagnosed with ACTLC from January 2013 to December 2022. Two experienced radiologists independently reviewed CT and MR images to confirm the ACTLC diagnosis and document radiologic findings. Clinical data, including symptoms and laboratory results, were also assessed. The study received approval from the institutional ethics committee, with patient consent waived.
RESULTS: The cohort had a mean age of 49 years and included 19 females (63%). All patients presented with acute cervicalgia, and 29 (97%) exhibited calcifications at the C1-C2 level. A novel imaging feature, termed the "beak sign," was observed in 24 of these 29 patients (83%), defined by an acute angle at the margin of calcification pointing towards the C1-C2 intervertebral space. Prevertebral soft-tissue oedema was present in all patients, with 25 (83%) also showing retropharyngeal fluid accumulation. Among the 14 patients who underwent MRI, 11 (79%) exhibited atlantoaxial joint effusion, a feature rarely reported in ACTLC. Follow-up imaging revealed inferior migration of calcifications in 2 patients, with 1 developing a cyst-like appearance in the post-calcific phase-an unreported finding in ACTLC.
CONCLUSIONS: This study represents the largest ACTLC cohort confirmed by cross-sectional imaging. Prevertebral calcifications and soft-tissue oedema were consistently observed in all patients, with the majority also exhibiting retropharyngeal fluid accumulation. This article introduces the "beak sign," a novel imaging finding observed in most cases, and identifies atlantoaxial joint effusion as a newly recognized, common imaging manifestation in ACTLC.
ADVANCES IN KNOWLEDGE: This review of 30 patients with acute calcific tendinitis of the longus colli introduces the "beak sign"-an acute angle at the calcification margin pointing towards the C1-C2 intervertebral space-as a novel imaging feature observed in most cases. Additionally, it identifies atlantoaxial joint effusion as a newly recognized, common imaging manifestation of this condition.
METHODS: This retrospective, cross-sectional study analysed 30 patients diagnosed with ACTLC from January 2013 to December 2022. Two experienced radiologists independently reviewed CT and MR images to confirm the ACTLC diagnosis and document radiologic findings. Clinical data, including symptoms and laboratory results, were also assessed. The study received approval from the institutional ethics committee, with patient consent waived.
RESULTS: The cohort had a mean age of 49 years and included 19 females (63%). All patients presented with acute cervicalgia, and 29 (97%) exhibited calcifications at the C1-C2 level. A novel imaging feature, termed the "beak sign," was observed in 24 of these 29 patients (83%), defined by an acute angle at the margin of calcification pointing towards the C1-C2 intervertebral space. Prevertebral soft-tissue oedema was present in all patients, with 25 (83%) also showing retropharyngeal fluid accumulation. Among the 14 patients who underwent MRI, 11 (79%) exhibited atlantoaxial joint effusion, a feature rarely reported in ACTLC. Follow-up imaging revealed inferior migration of calcifications in 2 patients, with 1 developing a cyst-like appearance in the post-calcific phase-an unreported finding in ACTLC.
CONCLUSIONS: This study represents the largest ACTLC cohort confirmed by cross-sectional imaging. Prevertebral calcifications and soft-tissue oedema were consistently observed in all patients, with the majority also exhibiting retropharyngeal fluid accumulation. This article introduces the "beak sign," a novel imaging finding observed in most cases, and identifies atlantoaxial joint effusion as a newly recognized, common imaging manifestation in ACTLC.
ADVANCES IN KNOWLEDGE: This review of 30 patients with acute calcific tendinitis of the longus colli introduces the "beak sign"-an acute angle at the calcification margin pointing towards the C1-C2 intervertebral space-as a novel imaging feature observed in most cases. Additionally, it identifies atlantoaxial joint effusion as a newly recognized, common imaging manifestation of this condition.