ABSTRACT
BACKGROUND: Calcific tendinitis of the longus colli muscle is an aseptic inflammatory reaction to calcium hydroxyapatite crystal deposition in the cervical prevertebral space. CASE PRESENTATION: A 40-year-old woman presented with neck pain and odonyphagia. She had reduced mobility in her neck, tenderness to palpation and elevated CRP with normal leukocyte count and sedimentation rate. CT revealed a fluid collection in the retropharyngeal space and a calcific deposition in the longus colli muscle consistent with calcific tendinitis. She improved with NSAID therapy. Blood cultures taken on arrival showed no growth. INTERPRETATION: Acute calcific tendinitis of the longus colli muscle is an aseptic inflammatory process in the cervical prevertebral space and an important mimicker of retropharyngeal abscess and spondylodiscitis.
Subject(s)
Calcinosis , Tendinopathy , Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Calcinosis/diagnostic imaging , Diagnosis, Differential , Female , Humans , Neck Muscles/diagnostic imaging , Neck Pain/diagnostic imaging , Neck Pain/etiology , Tendinopathy/diagnostic imaging , Tendinopathy/drug therapyABSTRACT
BACKGROUND: The aim of anticoagulation treatment is to reach an optimal international normalised ratio (INR) level in which the risk of thrombosis as well as bleeding is minimal. Recently developed methods that allow self-managed control of anticoagulation make more frequent testing possible and may thus represent a better alternative than conventional control. MATERIAL AND METHODS: In this meta-analysis, randomized, controlled trials comparing self-management with conventional control with regard to time in therapeutic range and number of bleedings and thromboses were investigated. Eight clinical trials fulfilled the criteria for inclusion, representing about 870 patient-years and 1300 patients. RESULTS: The difference in time in therapeutic range was on average 10% in favour of self-management. The rate of major and fatal bleedings was 3.5% per patient-years with conventional control, 2.4% per patient-years with self-management. The rate of thrombosis was 3.9% per patient-years with conventional control as against 2.7% with self-management. OddsratioMH for major clinical events was 0.62 (95% CI 0.429, 0.895); p < 0.01. INTERPRETATION: This meta-analysis shows that self-managed control of anticoagulation improves safety and efficacy and is probably a better alternative than conventional control for selected groups of patients.
