Presentation
Occipital headache and neck pain for 2 months with nausea and vomiting.
Patient Data
Widening of prevertebral soft tissue at the level of C2 reaching 10 mm (N<7 mm).
Non-contrast CT showed enlargement of prevertebral soft tissues on left side of the neck with a hypodense core. Bone erosions of the left side of the atlas and left occipital condyle are noted.
Post-contrast CT shows diffuse enlargement of soft tissues of the left side of the upper neck with heterogeneous enhancement and central non-enhancing areas of internal necrosis.
Case Discussion
CT features are in keeping with a left-sided retropharyngeal abscess with oseomyelitis of atlas and left occipital condyle. Laboratory tests revealed tuberculous abscess.
Widening of prevertebral soft tissue shadow on lateral cervical x-ray is indicative of a prevertebral pathology. The normal thickness at the level of C2 is less than 7 mm 1.
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