Case of the Month: January, 2012, Page 2

Answer: D) Edema of the longuscolli musculature with associated retropharnyngeal fluid and pre-odontoid calcification.

Imaging Findings:

  • There is non-enhancing fluid in the retropharyngeal space with amorphous calcification present in the midline, anterior to the odontoid process, and just inferior to the articulation of C1 and C2. The longuscolli musculature anterior to the cervical spine is enlarged and edematous.
  • The outside MRI reading likely confused the calcification for gas (both are low signal on MRI) and concluded abscess given the presence of retropharyngeal fluid.

What is the Treatment for this condition?

  1. Broad spectrum antibiotics.
  2. High dose steroids.
  3. Urgent surgical intervention.
  4. Anti-inflammatory medications and supportive care.
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