Case of the Month: January, 2012

Submitted by Max Pollock, MD. and Marcel Maya, MD.

History: 46 year old female with 2 days of acute onset neck pain presents to the emergency department after an MRI at an outside facility showed what appeared to represent a retropharyngeal abscess. She was sent to the ED by her physician who was suspicious of the diagnosis as there were no objective signs of infection.

A CT scan of the neck with intravenous contrast was ordered for further evaluation.

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What is the Salient Finding?

1. Cervical fracture and edema.
2. Epidural collection causing cord compression.
3. Gas in the retropharyngeal space with enhancing fluid collection.
4. Edema of the longuscolli musculature with associated retropharnyngeal fluid and pre-odontoid calcification