title: Prevertebral tendinitis: how to avoid unnecessary surgical interventions.
abstract: OBJECTIVE
  Prevertebral tendinitis is an inflammatory process that affects the cervicothoracic prevertebral muscles. Because of its clinical presentation and imaging features in computed tomography scans, prevertebral tendinitis can easily be mistaken for deep cervical abscess formation. Totally different therapy regimens require clinical and diagnostic pathways for sufficient differentiation between those two pathologic entities.
  
  
  METHODS
  Case series with comparison.
  
  
  METHODS
  In 10 patients with prevertebral tendinitis, we evaluated the symptoms, laboratory reports, and radiological imaging findings. We compared these data to 65 patients with a deep cervical abscess formation. The basic radiologic imaging procedure was contrast-enhanced computed tomography. For detection of prevertebral tendinitis, we performed magnetic resonance imaging with diffusion-weighted images and calculated the apparent diffusion coefficient map.
  
  
  RESULTS
  Patients with prevertebral tendinitis complained of severe neck pain, globus sensation, and neck stiffness. Diffusion-weighted images showed a typical benign prevertebral effusion. Computed tomography scans showed amorphous calcifications in the tendon of the prevertebral muscles. The C-reactive protein values were slightly increased in patients with prevertebral tendinitis, and white blood cell count remained normal. In comparison to patients with deep cervical abscess formation, the C-reactive protein and white blood cell count was significantly lower (P < .05) in the prevertebral tendinitis cases.
  
  
  CONCLUSIONS
  Prevertebral tendinitis should be considered when patients suffer from neck pain, neck stiffness, and globus sensations despite low signs of inflammation in the laboratory report. To confirm the diagnosis, the best imaging feature is magnetic resonance imaging with diffusion-weighted images and apparent diffusion coefficient map.
authors.affiliation: ENT University Hospital Graz, Medical University of Graz, Graz, Austria. georg.hammer@medunigraz.at
authors.forename: Georg Philipp
authors.initials: GP
authors.lastname: Hammer
authors.forename: Robert
authors.initials: R
authors.lastname: Vollmann
authors.forename: Peter Valentin
authors.initials: PV
authors.lastname: Tomazic
authors.forename: Josef
authors.initials: J
authors.lastname: Simbrunner
authors.forename: Gerhard
authors.initials: G
authors.lastname: Friedrich
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D052256:Tendinopathy / Q000175:diagnosis* / Q000601:surgery; D013904:Thoracic Vertebrae; D019564:Unnecessary Procedures