Longus colli attaches via short tendinous slips to the anterior vertebral bodies, transverse processes, and atlas, functioning as the primary prevertebral cervical stabiliser. Its upper oblique fibres attach to the anterior arch of C1 via a well-defined tendinous insertion.
Calcific tendinitis of longus colli at the C1-C2 level produces an acute painful neck syndrome with dysphagia and restricted neck movement, radiating to the occiput. CT demonstrates calcific deposits anterior to C1-C2. The condition is self-limiting, treated with NSAIDs and a soft collar. It must be distinguished from retropharyngeal abscess, which it may mimic clinically.
Acute calcium hydroxyapatite deposition at the C1 attachment producing severe neck stiffness, odynophagia, and a retropharyngeal soft tissue shadow on lateral neck X-ray, mimicking a retropharyngeal abscess.
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