The tendon of the longus colli muscle is an unusual location for a common condition. Acute inflammation with calcareous deposits is similar in radiographic and clinical presentation to acute calcific tendinitis in common locations, such as the supraspinatus tendon in the shoulder. The radiographic finding is characteristic amorphous calcification localized anterior to C1 with associated swelling of the prevertebral soft tissues from C1 through C4. After the acute phase, calcification becomes more poorly defined and begins to resorb, with resorption usually complete by 1-2 weeks. The clinical feature is rather sudden onset of severe pain in the neck and throat aggravated by swallowing and movement of the head; this may be associated with mild fever and elevation of sedimentation rate. Pain reaches a maximum at 2-5 days, then gradually subsides, usually completely by 1-2 weeks.