Calcium hydroxyapatite crystal deposition with intraosseous penetration involving the posterior side of the cervical backbone: a beforehand unreported reason for neck ache.
Eur Backbone J. 2017 Could;26(Suppl 1):53-57
Authors: Urrutia J, Contreras O
PURPOSE: Calcific tendinitis is a frequent dysfunction attributable to hydroxyapatite crystal deposition; nevertheless, bone erosions from calcific tendinitis are uncommon. The spinal manifestation of this illness is calcific tendinitis of the longus colli muscle; this illness has by no means been described within the posterior side of the backbone. We report a case of calcium hydroxyapatite crystal deposition involving the posterior cervical backbone eroding the bone cortex.
METHODS: A 57-year-old lady offered with a 5-month historical past of left-sided neck ache. Radiographs confirmed C4-C5 interspinous calcification with lytic compromise of the posterior arch of C4. Magnetic resonance imaging confirmed a lytic lesion of the posterior arch of C4, with a mushy tissue mass extending to the C4-C5 interspinous house; calcifications have been noticed as very low sign depth areas on T1 and T2 sequences, surrounded by gadolinium-enhanced mushy tissues. A computed tomography (CT) scan confirmed the bone erosions and the mushy tissue calcifications.
RESULTS: A CT-guided needle biopsy was carried out; it confirmed vascularized connective tissue with inflammatory histiocytic infiltration and multinucleated big cells; Alizarin Pink stain confirmed the presence of hydroxyapatite crystals. The affected person was handled with anti-inflammatories for two weeks. She has been asymptomatic in a 6-month follow-up; a CT scan on the final follow-up revealed reparative reworking of bone erosions.
CONCLUSION: That is the primary report of calcium hydroxyapatite crystal deposition with intraosseous penetration involving the posterior side of the cervical backbone. Contemplating that this uncommon lesion may be misinterpreted as a tumor or an infection, excessive suspicion is required to keep away from pointless surgical procedures.
PMID: 27492725 [PubMed – indexed for MEDLINE]