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Patient with Neck Pain, Dysphagia and Trismus

Slide 1:  Pt in 50’s with new onset of neck pain, dysphagia and trismus.

Slides 2-3:  There is no hx of esophageal trauma or excessive vomiting.  There is retropharyngeal fluid tracking along the fascial planes.

Slides 4-5:  This is not an early abscess.  What clinches the diagnosis is the abnormality inferior to the anterior arch of C1.

Slide 6:  This is a case of calcific tendinitis of the longus coli muscles (deposition of hydroxyapatite crystals).  It is usually treated with steroids instead of Abx.  Neck pain is often sudden and can be accompanied by odynophagia.  Mild leukocystosis and fever should not dissuade you from this diagnosis.