Pain in the Neck: Atypical Causes of Nontraumatic Neck Pain

There is an extensive differential diagnosis for nontraumatic neck pain, the most common of which is well known and understood by radiologists and clinicians alike. Although cross-sectional imaging of the neck has become a ubiquitous and invaluable tool in the work-up of neck pain, there still exist several atypical entities with subtle imaging findings that radiologists should consider before dismissing a study result as negative. In this review, we discuss several such diagnostic challenges, including extracranial cervical artery dissection, Eagle syndrome, glossopharyngeal neuralgia, pharyngeal mucositis, carotidynia, and calcific tendinitis of the longus colli muscles. With increased knowledge of these entities, radiologists can improve patient care and continue to be integral in patient diagnosis, especially in cases of atypical nontraumatic neck pain.

Learning Objective: To pictorially review several rare and/or atypical causes of neck pain, with particular attention to those entities with subtle radiologic findings that may not be discernable via conventional search patterns.