title: [Crowned dens syndrome: three new cases].
abstract: BACKGROUND
  Crowned dens syndrome is due to a microcrystalline infringement (hydroxyapatite or calcium pyrophosphate) of the retro-odontoidal ligament of atlas, often leading to the erroneous diagnosis of meningitis or spondylitis. We report on three new cases diagnosed from 1996 to 1999.
  
  
  METHODS
  The patients complained of cervicalgies, headaches or fever. The initially evoked diagnoses were meningitis, spondylodiscitis or endocarditis. Clinical exam found meningism and an inflammatory syndrome in all patients. Analysis of the cerebro-spinal fluid realised in two cases was normal. The diagnosis of crowned dens syndrome was assessed in two cases by cervical CT scan of C1/C2. In the third case, chondrocalcinosis of a wrist allowed this diagnosis. We report a probably non fortuitous case of crowned dens syndrome associated with genetic hemochromatosis. A non steroidal anti-inflammatory treatment allowed a dramatic regression of clinical symptoms.
  
  
  CONCLUSIONS
  This entity should be better known; it can mimick numerous diagnosis and be responsible for fever in the long course.
authors.affiliation: Service de médecine interne, hôpital Foch, Suresnes, France. achile.aouba@wanadoo.fr
authors.forename: A
authors.initials: A
authors.lastname: Aouba
authors.forename: O
authors.initials: O
authors.lastname: Lidove
authors.forename: P
authors.initials: P
authors.lastname: Gepner
authors.forename: C
authors.initials: C
authors.lastname: Brousse
authors.forename: A
authors.initials: A
authors.lastname: Somogyi
authors.forename: A-M
authors.initials: AM
authors.lastname: Piette
authors.forename: A
authors.initials: A
authors.lastname: Scherrer
authors.forename: P
authors.initials: P
authors.lastname: Graveleau
authors.forename: M
authors.initials: M
authors.lastname: De Bandt
authors.forename: B
authors.initials: B
authors.lastname: Patri
authors.forename: O
authors.initials: O
authors.lastname: Blétry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002131:Calcium Pyrophosphate; D001270:Cervical Atlas / Q000473:pathology*; D002805:Chondrocalcinosis / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D017886:Durapatite; D006801:Humans; D008297:Male; D008581:Meningitis / Q000175:diagnosis; D013166:Spondylitis / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D017886:Durapatite; D002131:Calcium Pyrophosphate