[Acute neck pain in an elderly patient].
Case report of an 85-year-old patient with acute neck pain and elevated parameters of inflammation in the blood. The symptoms and the MRI of the cervical spine were misleading and mimicked an infectious spondylitis with abscess formation in the prevertebral soft tissue and the dens. Lack of improvement following intravenous antibiotics led to an investigation of the spine by computed tomography showing typical calcifications of the transverse ligament around the odontoid process. Crowned dens syndrome, the cervical manifestation of calcium pyrophosphate dehydrate deposition disease, was diagnosed. After insufficient response to NSAIDs, oral glucocorticoids quickly resulted in complete relief of symptoms.
Klinik für Rheumatologie und Rehabilitation, Stadtspital Triemli, Zürich. Claudia.Pfeiffer@triemli.stzh.ch
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Pfeiffer Zehnder
D000369:Aged, 80 and over; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D002574:Cervical Vertebrae / Q000473:pathology; D002805:Chondrocalcinosis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004630:Emergencies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019547:Neck Pain / Q000209:etiology*; D009809:Odontoid Process / Q000473:pathology; D025241:Spondylarthritis / Q000175:diagnosis*; D013166:Spondylitis / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
D002097:C-Reactive Protein