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.
Australian Pathways for Specialist Pain Management and Early Palliative Care for People With Pancreatic Cancer: Developed Using a Community Consensus Approach
Jennifer Philip, Melanie R. Lovell, Kylee Bellingham, Gail Garvey, Gregory B. Crawford, Nicole M. Rankin, Kara Burns, Isabel Young, Vivienne Milch, Dorothy Keefe, Katrina Anderson, James Lawson, Meinir Krishnasamy
Paracetamol in Pregnancy: Uncertain Evidence, Certain Consequences
David J. Tunnicliffe, Miranda Cumpston, Debra Kennedy, Margie Danchin, Armando Teixeira-Pinto
Severe Hypoglycaemia Secondary to Chronic Opioid-Induced Hypothalamic–Pituitary–Adrenal Axis Suppression: An Under-Recognised Phenomenon
Michael Do, Annabelle Hayes, Malgorzata Brzozowska