Photo Quiz

Neck Crepitus in a Runner


Am Fam Physician. 2017 Jan 15;95(2):113-115.

A 27-year-old man presented with constant right-sided neck, throat, and ear pain that began one day earlier after he completed an uneventful five-mile trail run. There were no alleviating or exacerbating factors for the pain. He did not have trauma or injury to the area. He reported a vague sensation of fluid moving around in his neck and a strange feeling in his throat with swallowing. He did not have dysphagia, odynophagia, fever, chills, or respiratory symptoms. He did not use drugs or alcohol.

On physical examination, he was well appearing with normal vital signs and normal oxygen saturation on room air. An ear examination was normal. The neck examination revealed minimally palpable crepitus at the right lateral aspect of the base of the neck. There was no skin warmth or erythema. Soft tissue neck radiography was performed (Figure 1 and Figure 2).

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Figure 1

Figure 1

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Figure 2

Figure 2


Based on the patient's history, physical examination, and radiography findings, which one of the following is the most likely

Address correspondence to Bernadette Kiraly, MD, at Reprints are not available from the author.

Author disclosure: No relevant financial affiliations.


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This series is coordinated by John E. Delzell Jr., MD, MSPH, Assistant Medical Editor.

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