颈长肌急性钙化性肌腱炎：病例系列及文献综述。

文献信息

中文摘要

引言： 回顾本机构颈长肌急性钙化性肌腱炎（ACTLC）的表现与治疗以及现有文献，以更好地界定这一疾病过程并促进其诊断和治疗，特别关注部署的军事环境。
材料与方法： 对来自2个军事治疗机构的5例ACTLC患者进行回顾性病历审查。随后，对已报道的ACTLC病例进行文献综述，并记录每例的相关发现。将这些数据汇总并与我们的系列进行比较。
结果： 在我们的系列5例患者中，5/5表现为颈部疼痛和颈部活动范围（ROM）受限，4/5表现为吞咽痛，1/5有发热。柔性喉镜检查显示1/4例有咽后壁水肿。1/5例存在白细胞增多；2/2例CRP升高，2/3例ESR升高。CT成像显示5/5例有椎前钙化，4/5例有咽后积液/水肿。治疗包括NSAIDs、皮质类固醇和抗生素的不同组合，症状缓解的平均时间为3.8天（±2.4）。文献综述共纳入107例患者。历史病例的汇总数据与我们的系列高度相似。
结论： 颈长肌急性钙化性肌腱炎表现为急性颈部疼痛、颈部ROM受限和吞咽痛，CT通常可见咽后积液/水肿；炎症标志物升高也很常见。椎前钙化这一特征性影像学发现可将其与深部颈部间隙感染区分开来，并避免不必要的干预，因为ACTLC是自限性的，通常使用NSAIDs即可缓解。在部署环境中，识别和正确管理这一疾病对于避免不必要的医疗后送、有效利用稀缺资源以及防止部队战斗力下降至关重要。

英文摘要

INTRODUCTION: To review the presentation and treatment of acute calcific tendonitis of the longus colli muscle (ACTLC) at our institution and the existing literature to better define this disease process and facilitate its diagnosis and treatment, with special attention to the deployed military environment.
MATERIALS AND METHODS: A retrospective chart review of 5 patients with ACTLC from 2 military treatment facilities was performed. Next, a literature review of reported cases of ACTLC was performed, and relevant findings for each case were recorded. This data was pooled and compared to that of our series.
RESULTS: Of the 5 patients in our series, 5/5 presented with neck pain and limited neck range of motion (ROM), 4/5 presented with odynophagia, and 1/5 was febrile. Flexible laryngoscopy showed posterior pharyngeal wall edema in 1/4. Leukocytosis was present in 1/5; CRP was elevated in 2/2, and ESR was elevated in 2/3. CT imaging showed prevertebral calcification in 5/5 and retropharyngeal effusion/edema in 4/5. Treatment consisted of different combinations of NSAIDs, corticosteroids, and antibiotics, and the average time to symptom resolution was 3.8 days (±2.4). The literature review yielded a total of 107 patients. The pooled data from historical cases closely mirrored that of our series.
CONCLUSIONS: Acute calcific tendonitis of the longus colli muscle presents with acute neck pain, limited neck ROM, and odynophagia with retropharyngeal effusion/edema usually seen on CT; elevated inflammatory markers are also common. The characteristic imaging finding of prevertebral calcification can differentiate it from deep neck space infections and prevent unnecessary interventions, as ACTLC is self-limited and typically resolves with NSAIDs. Recognition and proper management of this condition is critical in a deployed setting to prevent unnecessary medical evacuation, allow efficient utilization of scarce resources, and prevent degradation of unit combat effectiveness.