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Retropharyngeal Space Edema
Bronwyn E. Hamilton, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Retropharyngeal space (RPS)
              • Synonyms

                • Retropharyngeal effusion, benign retropharyngeal fluid
              • Definitions

                • Accumulation of sterile fluid, effacing RPS fat

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            • Reporting Tips

                                              Selected References

                                              1. Aiken AH et al: Approach to masses in head and neck spaces. In: Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging. [Internet]. Hodler J et al, editors. Cham: Springer, 2020
                                              2. Lim S et al: Deep neck inflammation: probable Kawasaki disease in Korean children. Clin Exp Otorhinolaryngol. 13(1):77-82, 2020
                                              3. Mnatsakanian A et al: Anatomy, Head and Neck, Retropharyngeal Space 2020 in StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020
                                              4. Appachi S et al: Spontaneous cervical chyle fistula: A case report. Am J Otolaryngol. 40(4):598-600, 2019
                                              5. Au DCY et al: Kawasaki disease with retropharyngeal edema: case series from a single center experience. Chin Med J (Engl). 132(14):1753-4, 2019
                                              6. Chapman SC et al: Lemierre's syndrome: an atypical presentation. Ann Vasc Surg. 60:479.e1-4, 2019
                                              7. Inagaki K et al: Deep neck space involvement of Kawasaki disease in the US: a population-based study. J Pediatr. 215:118-22, 2019
                                              8. Naik PP et al: Longus colli tendinitis: the lost twin of retropharyngeal abscess. Indian J Otolaryngol Head Neck Surg. 71(Suppl 1):771-5, 2019
                                              9. Ratzon R et al: Thrombosis, anticoagulation and outcomes in malignant superior vena cava syndrome. J Thromb Thrombolysis. 47(1):121-8, 2019
                                              10. Bhatt AA: Non-traumatic causes of fluid in the retropharyngeal space. Emerg Radiol. 25(5):547-51, 2018
                                              11. Zimmerman S et al: Rapid Fire: Superior Vena Cava Syndrome. Emerg Med Clin North Am. 36(3):577-584, 2018
                                              12. Hsu CH et al: An unusual case of focal segmental glomerulosclerosis presenting with retropharyngeal edema. Eur Ann Otorhinolaryngol Head Neck Dis. 133(5):355-356, 2016
                                              13. Al-Natour MS et al: Superior vena cava syndrome with retropharyngeal edema as a complication of ventriculoatrial shunt. Clin Case Rep. 3(10):777-80, 2015
                                              14. Nomura O et al: Comparison of patients with Kawasaki disease with retropharyngeal edema and patients with retropharyngeal abscess. Eur J Pediatr. 173(3):381-6, 2014
                                              15. Nomura O et al: Comparison of patients with Kawasaki disease with retropharyngeal edema and patients with retropharyngeal abscess. Eur J Pediatr. 173(3):381-6, 2014
                                              16. Puhakka L et al: Retropharyngeal involvement in Kawasaki disease--a report of four patients with retropharyngeal edema verified by magnetic resonance imaging. Int J Pediatr Otorhinolaryngol. 78(10):1774-8, 2014
                                              17. Katsumata N et al: Characteristics of cervical computed tomography findings in kawasaki disease: a single-center experience. J Comput Assist Tomogr. 37(5):681-5, 2013
                                              18. Nurata H et al: Retropharyngeal hematoma secondary to whiplash injury in childhood: a case report. Turk Neurosurg. 22(4):521-3, 2012
                                              19. Paik NC et al: Tendinitis of longus colli: computed tomography, magnetic resonance imaging, and clinical spectra of 9 cases. J Comput Assist Tomogr. 36(6):755-61, 2012
                                              20. Vollmann R et al: Pathways in the diagnosis of prevertebral tendinitis. Eur J Radiol. 81(1):114-7, 2012
                                              21. Hoang JK et al: Multiplanar CT and MRI of collections in the retropharyngeal space: is it an abscess? AJR Am J Roentgenol. 196(4):W426-32, 2011
                                              22. Jordan MT et al: Esophageal foreign body sensation: a rare presentation of angioedema. J Emerg Med. 39(2):174-7, 2010
                                              23. Langley EW et al: Retropharyngeal edema: an unusual manifestation of Kawasaki disease. J Emerg Med. 39(2):181-5, 2010
                                              24. Rizk NN et al: Case report: mediastinal hematoma secondary to hypertension, presenting as a retropharyngeal space abscess. Laryngoscope. 120 Suppl 4:S179, 2010
                                              25. Ellika SK et al: Acute calcific tendinitis of the longus colli: an imaging diagnosis. Dentomaxillofac Radiol. 37(2):121-4, 2008
                                              26. Spennato P et al: Retropharyngeal cerebrospinal fluid collection as a cause of postoperative dysphagia after anterior cervical discectomy. Surg Neurol. 67(5):499-503; discussion 503, 2007
                                              27. Gelineck J et al: Retropharyngeal tendinitis: radiographic and magnetic resonance imaging findings. Acta Radiol. 47(8):806-9, 2006
                                              28. Anagnostara A et al: Traumatic retropharyngeal hematoma and prevertebral edema induced by whiplash injury. Emerg Radiol. 11(3):145-9, 2005
                                              29. Kurihara N et al: Edema in the retropharyngeal space associated with head and neck tumors: CT imaging characteristics. Neuroradiology. 47(8):609-15, 2005
                                              30. Vural C et al: Accuracy of computerized tomography in deep neck infections in the pediatric population. Am J Otolaryngol. 24(3):143-8, 2003
                                              31. Mihmanli I et al: Inflammation of vertebral bone associated with acute calcific tendinitis of the longus colli muscle. Neuroradiology. 43(12):1098-101, 2001
                                              32. Muñoz A et al: Acute neck infections: prospective comparison between CT and MRI in 47 patients. J Comput Assist Tomogr. 25(5):733-41, 2001
                                              33. Chong VF et al: Radiology of the retropharyngeal space. Clin Radiol. 55(10):740-8, 2000
                                              34. Altman KW et al: Angioedema presenting in the retropharyngeal space in an adult. Am J Otolaryngol. 20(2):136-8, 1999
                                              35. Boucher C et al: Retropharyngeal abscesses: a clinical and radiologic correlation. J Otolaryngol. 28(3):134-7, 1999
                                              36. Stone ME et al: Correlation between computed tomography and surgical findings in retropharyngeal inflammatory processes in children. Int J Pediatr Otorhinolaryngol. 49(2):121-5, 1999
                                              37. Eastwood JD et al: Retropharyngeal effusion in acute calcific prevertebral tendinitis: diagnosis with CT and MR imaging. AJNR Am J Neuroradiol. 19(9):1789-92, 1998
                                              38. De Maeseneer M et al: Calcific tendinitis of the longus colli muscle. Head Neck. 19(6):545-8, 1997
                                              39. Plewa MC et al: Benign cervical prevertebral soft tissue swelling in traumatic asphyxia. J Trauma. 38(6):937-40, 1995
                                              40. Poe LB et al: Acute internal jugular vein thrombosis associated with pseudoabscess of the retropharyngeal space. AJNR Am J Neuroradiol. 16(4 Suppl):892-6, 1995
                                              41. Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part I. Expected changes. Radiology. 193(1):141-8, 1994
                                              42. Ring D et al: Acute calcific retropharyngeal tendinitis. Clinical presentation and pathological characterization. J Bone Joint Surg Am. 76(11):1636-42, 1994
                                              43. Glasier CM et al: CT and ultrasound imaging of retropharyngeal abscesses in children. AJNR Am J Neuroradiol. 13(4):1191-5, 1992
                                              44. Davis WL et al: The normal and diseased infrahyoid retropharyngeal, danger, and prevertebral spaces. Semin Ultrasound CT MR. 12(3):241-56, 1991
                                              45. Davis WL et al: Retropharyngeal space: evaluation of normal anatomy and diseases with CT and MR imaging. Radiology. 174(1):59-64, 1990
                                              46. Artenian DJ et al: Acute neck pain due to tendonitis of the longus colli: CT and MRI findings. Neuroradiology. 31(2):166-9, 1989
                                              47. Myssiorek D et al: Traumatic retropharyngeal hematoma. Arch Otolaryngol Head Neck Surg. 115(9):1130-2, 1989
                                              48. Sneed WF et al: Retropharyngeal pseudomasses. South Med J. 77(4):528-30, 1984
                                              49. Hayden CK Jr et al: Retropharyngeal edema, airway obstruction, and caval thrombosis. AJR Am J Roentgenol. 138(4):757-8, 1982
                                              50. Weinberg S et al: Retropharyngeal tendinitis. Laryngoscope. 92(2):181-2, 1982
                                              51. Bryan CS et al: Retropharyngeal infection in adults. Arch Intern Med. 134(1):126-30, 1974
                                              Related Anatomy
                                              Loading...
                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Retropharyngeal space (RPS)
                                                          • Synonyms

                                                            • Retropharyngeal effusion, benign retropharyngeal fluid
                                                          • Definitions

                                                            • Accumulation of sterile fluid, effacing RPS fat

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Ultrasonographic Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      • Image Interpretation Pearls

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Aiken AH et al: Approach to masses in head and neck spaces. In: Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging. [Internet]. Hodler J et al, editors. Cham: Springer, 2020
                                                                                          2. Lim S et al: Deep neck inflammation: probable Kawasaki disease in Korean children. Clin Exp Otorhinolaryngol. 13(1):77-82, 2020
                                                                                          3. Mnatsakanian A et al: Anatomy, Head and Neck, Retropharyngeal Space 2020 in StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020
                                                                                          4. Appachi S et al: Spontaneous cervical chyle fistula: A case report. Am J Otolaryngol. 40(4):598-600, 2019
                                                                                          5. Au DCY et al: Kawasaki disease with retropharyngeal edema: case series from a single center experience. Chin Med J (Engl). 132(14):1753-4, 2019
                                                                                          6. Chapman SC et al: Lemierre's syndrome: an atypical presentation. Ann Vasc Surg. 60:479.e1-4, 2019
                                                                                          7. Inagaki K et al: Deep neck space involvement of Kawasaki disease in the US: a population-based study. J Pediatr. 215:118-22, 2019
                                                                                          8. Naik PP et al: Longus colli tendinitis: the lost twin of retropharyngeal abscess. Indian J Otolaryngol Head Neck Surg. 71(Suppl 1):771-5, 2019
                                                                                          9. Ratzon R et al: Thrombosis, anticoagulation and outcomes in malignant superior vena cava syndrome. J Thromb Thrombolysis. 47(1):121-8, 2019
                                                                                          10. Bhatt AA: Non-traumatic causes of fluid in the retropharyngeal space. Emerg Radiol. 25(5):547-51, 2018
                                                                                          11. Zimmerman S et al: Rapid Fire: Superior Vena Cava Syndrome. Emerg Med Clin North Am. 36(3):577-584, 2018
                                                                                          12. Hsu CH et al: An unusual case of focal segmental glomerulosclerosis presenting with retropharyngeal edema. Eur Ann Otorhinolaryngol Head Neck Dis. 133(5):355-356, 2016
                                                                                          13. Al-Natour MS et al: Superior vena cava syndrome with retropharyngeal edema as a complication of ventriculoatrial shunt. Clin Case Rep. 3(10):777-80, 2015
                                                                                          14. Nomura O et al: Comparison of patients with Kawasaki disease with retropharyngeal edema and patients with retropharyngeal abscess. Eur J Pediatr. 173(3):381-6, 2014
                                                                                          15. Nomura O et al: Comparison of patients with Kawasaki disease with retropharyngeal edema and patients with retropharyngeal abscess. Eur J Pediatr. 173(3):381-6, 2014
                                                                                          16. Puhakka L et al: Retropharyngeal involvement in Kawasaki disease--a report of four patients with retropharyngeal edema verified by magnetic resonance imaging. Int J Pediatr Otorhinolaryngol. 78(10):1774-8, 2014
                                                                                          17. Katsumata N et al: Characteristics of cervical computed tomography findings in kawasaki disease: a single-center experience. J Comput Assist Tomogr. 37(5):681-5, 2013
                                                                                          18. Nurata H et al: Retropharyngeal hematoma secondary to whiplash injury in childhood: a case report. Turk Neurosurg. 22(4):521-3, 2012
                                                                                          19. Paik NC et al: Tendinitis of longus colli: computed tomography, magnetic resonance imaging, and clinical spectra of 9 cases. J Comput Assist Tomogr. 36(6):755-61, 2012
                                                                                          20. Vollmann R et al: Pathways in the diagnosis of prevertebral tendinitis. Eur J Radiol. 81(1):114-7, 2012
                                                                                          21. Hoang JK et al: Multiplanar CT and MRI of collections in the retropharyngeal space: is it an abscess? AJR Am J Roentgenol. 196(4):W426-32, 2011
                                                                                          22. Jordan MT et al: Esophageal foreign body sensation: a rare presentation of angioedema. J Emerg Med. 39(2):174-7, 2010
                                                                                          23. Langley EW et al: Retropharyngeal edema: an unusual manifestation of Kawasaki disease. J Emerg Med. 39(2):181-5, 2010
                                                                                          24. Rizk NN et al: Case report: mediastinal hematoma secondary to hypertension, presenting as a retropharyngeal space abscess. Laryngoscope. 120 Suppl 4:S179, 2010
                                                                                          25. Ellika SK et al: Acute calcific tendinitis of the longus colli: an imaging diagnosis. Dentomaxillofac Radiol. 37(2):121-4, 2008
                                                                                          26. Spennato P et al: Retropharyngeal cerebrospinal fluid collection as a cause of postoperative dysphagia after anterior cervical discectomy. Surg Neurol. 67(5):499-503; discussion 503, 2007
                                                                                          27. Gelineck J et al: Retropharyngeal tendinitis: radiographic and magnetic resonance imaging findings. Acta Radiol. 47(8):806-9, 2006
                                                                                          28. Anagnostara A et al: Traumatic retropharyngeal hematoma and prevertebral edema induced by whiplash injury. Emerg Radiol. 11(3):145-9, 2005
                                                                                          29. Kurihara N et al: Edema in the retropharyngeal space associated with head and neck tumors: CT imaging characteristics. Neuroradiology. 47(8):609-15, 2005
                                                                                          30. Vural C et al: Accuracy of computerized tomography in deep neck infections in the pediatric population. Am J Otolaryngol. 24(3):143-8, 2003
                                                                                          31. Mihmanli I et al: Inflammation of vertebral bone associated with acute calcific tendinitis of the longus colli muscle. Neuroradiology. 43(12):1098-101, 2001
                                                                                          32. Muñoz A et al: Acute neck infections: prospective comparison between CT and MRI in 47 patients. J Comput Assist Tomogr. 25(5):733-41, 2001
                                                                                          33. Chong VF et al: Radiology of the retropharyngeal space. Clin Radiol. 55(10):740-8, 2000
                                                                                          34. Altman KW et al: Angioedema presenting in the retropharyngeal space in an adult. Am J Otolaryngol. 20(2):136-8, 1999
                                                                                          35. Boucher C et al: Retropharyngeal abscesses: a clinical and radiologic correlation. J Otolaryngol. 28(3):134-7, 1999
                                                                                          36. Stone ME et al: Correlation between computed tomography and surgical findings in retropharyngeal inflammatory processes in children. Int J Pediatr Otorhinolaryngol. 49(2):121-5, 1999
                                                                                          37. Eastwood JD et al: Retropharyngeal effusion in acute calcific prevertebral tendinitis: diagnosis with CT and MR imaging. AJNR Am J Neuroradiol. 19(9):1789-92, 1998
                                                                                          38. De Maeseneer M et al: Calcific tendinitis of the longus colli muscle. Head Neck. 19(6):545-8, 1997
                                                                                          39. Plewa MC et al: Benign cervical prevertebral soft tissue swelling in traumatic asphyxia. J Trauma. 38(6):937-40, 1995
                                                                                          40. Poe LB et al: Acute internal jugular vein thrombosis associated with pseudoabscess of the retropharyngeal space. AJNR Am J Neuroradiol. 16(4 Suppl):892-6, 1995
                                                                                          41. Mukherji SK et al: Radiologic appearance of the irradiated larynx. Part I. Expected changes. Radiology. 193(1):141-8, 1994
                                                                                          42. Ring D et al: Acute calcific retropharyngeal tendinitis. Clinical presentation and pathological characterization. J Bone Joint Surg Am. 76(11):1636-42, 1994
                                                                                          43. Glasier CM et al: CT and ultrasound imaging of retropharyngeal abscesses in children. AJNR Am J Neuroradiol. 13(4):1191-5, 1992
                                                                                          44. Davis WL et al: The normal and diseased infrahyoid retropharyngeal, danger, and prevertebral spaces. Semin Ultrasound CT MR. 12(3):241-56, 1991
                                                                                          45. Davis WL et al: Retropharyngeal space: evaluation of normal anatomy and diseases with CT and MR imaging. Radiology. 174(1):59-64, 1990
                                                                                          46. Artenian DJ et al: Acute neck pain due to tendonitis of the longus colli: CT and MRI findings. Neuroradiology. 31(2):166-9, 1989
                                                                                          47. Myssiorek D et al: Traumatic retropharyngeal hematoma. Arch Otolaryngol Head Neck Surg. 115(9):1130-2, 1989
                                                                                          48. Sneed WF et al: Retropharyngeal pseudomasses. South Med J. 77(4):528-30, 1984
                                                                                          49. Hayden CK Jr et al: Retropharyngeal edema, airway obstruction, and caval thrombosis. AJR Am J Roentgenol. 138(4):757-8, 1982
                                                                                          50. Weinberg S et al: Retropharyngeal tendinitis. Laryngoscope. 92(2):181-2, 1982
                                                                                          51. Bryan CS et al: Retropharyngeal infection in adults. Arch Intern Med. 134(1):126-30, 1974