Type:
Educational Exhibit
Keywords:
Musculoskeletal soft tissue, CT, Other, Education and training
Authors:
W. Roughan, S. Do, A. Callinan
DOI:
10.26044/ranzcr2023/C-134
Imaging findings OR Procedure details
A 55 year old man presented to the emergency department with two days of severe right sided neck pain and swelling. These symptoms were accompanied by odynophagia and dysphonia. No preceding trauma or infections were reported. C-reactive protein was elevated at 65mg/L (<5.0mg/L) and white cell count was also raised at 11.4 x 109/L (4-11 x 109/L).
CT neck with contrast showed a heterogenous area of calcification measuring 13 x 5 x 10mm at the origin of the right middle scalene muscle, as seen in figures 1-4. The right middle scalene muscle appeared thickened with surrounding oedema tracking into the prevertebral space, as seen in figures 4-6. No defined collection was identified and the deep spaces of the neck were unremarkable. The imaging findings suggested calcific tendinitis of the right middle scalene muscle.
The patient responded well to simple oral analgesia and was discharged from the emergency department. At two week follow up with his GP, symptoms had essentially resolved and the decision was made to not proceed with any further imaging.