今井 則博, 竹田 欽一, 宇都宮 節夫, 多賀 雅浩, 伊藤 将倫, 今泉 延

Norihiro IMAI, Kinichi TAKEDA, Setsuo UTSUNOMIYA, Masahiro TAGA, Masatsugu ITOH, Tadashi IMAIZUMI

名古屋共立病院消化器内科

Department of Gastroenterology, Nagoya Kyoritsu Hospital

キーワード : calcific tendonitis, longus colli muscle, acute neck pain, ultrasonography

石灰沈着性頸長筋炎は急性頸部痛にて発症する疾患の一つである．臨床的には咽後膿瘍，髄膜炎，外傷との鑑別が重要であり，各種画像診断において頸椎前方の石灰化を確認する事により診断される．今回我々は，超音波検査にて頸長筋の石灰化を指摘し得た石灰沈着性頸長筋炎の1例を経験したので報告する．症例は92歳，男性，発熱，後頭部痛を主訴に当院受診．頸椎MRIにて椎体前方にT2 High intensity域を認め，石灰沈着性頸長筋炎を疑ったが，頸部単純Ｘ線検査，CTにて明らかな頸長筋の石灰化を認めなかった．頸部超音波検査にて頸長筋に石灰化を認め，石灰沈着性頸長筋炎と診断した．NSAIDS内服，頸椎カラー固定にて保存加療を行い，速やかな解熱とともに臨床症状の軽快を認めた．第11病日には頸部MRIにてT2 High intensity域の消失を認め，超音波検査にて石灰化の消失を認めた．石灰沈着性頸長筋炎に対し，頸部超音波検査が診断に有用であると考えられた．

Calcific tendinitis of the longus colli is an under-recognized cause of acute cervical pain. Clinically, it can be misdiagnosed as retropharyngeal abscess, meningitis, or traumatic injury. The diagnosis is made radiographically by identification of prevertebral soft tissue calcification. We present a case of calcific tendonitis of the longus colli detected by ultrasonography. The case was a 92-year-old man with a chief complaint of fever and posterior headache. MRI revealed diffuse swelling of the longus colli muscle as the signal intensity changed, especially on T2-weighted images. Although plain X-ray and CT did not show prevertebral soft tissue calcification, cervical ultrasonography revealed calcification of the longus colli. The patient was treated by medication with NSAIDs and local rest using a neck collar. After 11 days, MRI showed disappearance of soft tissue swelling, and ultrasonography revealed a decrease in the calcification. Ultrasonography may be useful for diagnosis of calcific tendonitis of the longus colli muscle.