Acute longus colli tendinitis: Case report of a rare cause of neck pain

Longus colli tendonitis is an uncommon aseptic inflammatory condition that affects the prevertebral longus colli tendon, which is a muscle that courses anteriorly from the level of the C1 to T3 vertebrae (1,2). Although longus colli tendonitis is a self-limited condition, the longus colli muscle is anterior to the prevertebral space and posterior to the pharyngeal constrictors, therefore when inflamed, leads to a myriad of symptoms that often mimic more serious conditions such as retropharyngeal abscess or meningitis (2). We present a case of a 39-year-old white male that presented with neck pain, neck stiffness, and pain with swallowing. Imaging findings on CT and MRI were consistent with a diagnosis of longus colli tendonitis. However, given the patient's presenting symptoms and elevated inflammatory lab markers, he was treated empirically with antibiotic therapy. This case report aims to educate on this condition and to discuss the diagnostic imaging findings to help avoid unnecessary treatments and interventions.