[Acute, hyperintense, and febrile cervicalgia. Crowned dens syndrome, a monofocal microcrystalline arthritis sometimes doubly misleading].
Microcrystalline arthritis sometimes have atypical localizations and presentations. The crowned dens syndrome, due to hydroxyapatite or calcium pyrophosphate deposits in peri-odontoid ligaments of the atlas, can provoke acute or chronic cervicalgia or misleading presentations such as meningitidis or fever of unknown origin. We present a particularly severe new case requesting urgent surgery, and a literature review to alert clinicians and prevent misdiagnosing this syndrome. Indeed, calcifications may be very discrete or just incidental and prevent a complete diagnostic approach.
Service de médecine interne, clinique médicale B, CHRU de Strasbourg, porte de l'Hôpital, Strasbourg, France.
T
T
Weitten
R
R
Mourot
J
J
Durckel
X
X
Buy
E
E
Andrès
D000208:Acute Disease; D000368:Aged; D001268:Atlanto-Axial Joint / Q000473:pathology*; D002114:Calcinosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D001270:Cervical Atlas / Q000473:pathology* / Q000601:surgery; D003078:Colchicine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004630:Emergencies; D005334:Fever / Q000209:etiology*; D006801:Humans; D017846:Longitudinal Ligaments / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000175:diagnosis; D019547:Neck Pain / Q000209:etiology*; D009408:Nerve Compression Syndromes / Q000209:etiology; D009809:Odontoid Process / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D016103:Spinal Fractures / Q000150:complications / Q000175:diagnosis*; D013123:Spinal Fusion; D013166:Spondylitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery
D003078:Colchicine