You are here

Article Text

Article menu
Download PDFPDF
Image challenge
Man with a royal headache and neck pain
  1. Kyra A Heuvelings1,
  2. Dennis G Barten1,
  3. Tim L Th A Jansen2
  1. 1 Department of Emergency Medicine, VieCuri Medical Center, Venlo, Netherlands
  2. 2 Department of Rheumatology, VieCuri Medical Center, Venlo, Netherlands
  1. Correspondence to Drs. Kyra A Heuvelings; kyraheuvelings{at}hotmail.com

https://doi.org/10.1136/emermed-2023-213785

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Clinical introduction

    A 71-year-old man presented to the ED with progressive headache and neck pain. The patient had no visual, neurological, chest or abdominal symptoms. Temperature was 38.8°C, he was fully conscious with no signs of meningeal irritation. C reactive protein was 85 mg/L. CXR and brain CT were unremarkable; cerebrospinal fluid analysis was normal. Because of the persistent symptoms, a cervical spine CT was performed during follow-up (figure 1).

    Figure 1

    CT cervical spine, coronal planes.

    Question

    What is the most likely diagnosis?

    1. Acute calcific tendinitis of the longus colli muscle (ACTLC)

    2. Rheumatoid arthritis (RA) of the cervical spine

    3. Pseudogout of the atlantoaxial junction

    4. Odontoid fracture type I

    Answer: C

    Pseudogout of …

    View Full Text

    Footnotes

    • Handling editor Sarah Edwards

    • X @BartenEM

    • Contributors TJ gave some background information about the disease. KH made the first draft. DB and TJ gave their feedback on the multiple versions and KH repeatedly processed the feedback. DB and TJ also provided their feedback during the multiple revisions. KH submitted the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.