Medical education
Snapshot
Volume 206 - Issue 5
Crowned dens syndrome: a rare cause of neck pain and fever
Authors: Matthew Jiang and Sukumar Navanathan
Med J Aust 2017; 206 (5): 199. || doi: 10.5694/mja16.01077
Published online: 20 March 2017
Published online: 20 March 2017
An 86-year-old man presented with acute severe neck pain, restricted neck movement and fever. The white cell count, erythrocyte sedimentation rate and C-reactive protein were all elevated. After excluding an infective aetiology, review of computed tomography images of the cervical spine (Figure) showed calcification of the transverse ligament of the atlas with crown-like density around the odontoid process. This was consistent with a diagnosis of crowned dens syndrome, an uncommon manifestation of calcium pyrophosphate dehydrate deposition disease.1,2 The patient’s symptoms were self-limiting over 1 week without the use of anti-inflammatories or corticosteroids.
References
- Lee GS, Kim RS, Park HK, Chang JC. Crowned dens syndrome: a case report and review of the literature. Korean J Spine 2014; 11: 15-17.
- Godfrin-Valnet M, Wendling D, Godfrin G, et al. AB1067 Eighteen cases of crowned dens syndrome: presentation and diagnosis. Ann Rheum Dis 2013; 71: 699.