title: Crowned dens syndrome: a rare cause of acute neck pain.
abstract: Crowned dens syndrome (CDS) is a rare but underrecognized cause of severe neck pain in older adults. It is characterized by acute onset pain and stiffness of the cervical spine. Accompanying fever and elevated inflammatory markers often lead to misdiagnosis. It is frequently associated with calcium pyrophosphate deposition disease, hydroxyapatite crystals, and sometimes other inflammatory conditions. Periodontoid calcification is seen on cervical computed tomography (CT) scan but is not typically visible on plain radiographs, making CT scanning invaluable in diagnosis. We describe a case of CDS in a 59-year-old woman, who presented with severe neck pain, elevated inflammatory markers, and progressive evolution in the appearance of her CT scans. The pathophysiology, clinical and radiographic findings, and dramatic response to corticosteroid therapy are reviewed.
authors: Division of Rheumatology, Department of Medicine, The University of British Columbia, 304-2828 Yew St, Vancouver, BC V6K 4W5, Canada.
authors: Mitchell
authors: M
authors: Uh
authors: Catharine
authors: C
authors: Dewar
authors: David
authors: D
authors: Spouge
authors: Kenneth
authors: K
authors: Blocka
mesh_terms: D002114:Calcinosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002131:Calcium Pyrophosphate / Q000378:metabolism; D002574:Cervical Vertebrae / Q000473:pathology; D017886:Durapatite / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D019547:Neck Pain / Q000150:complications* / Q000175:diagnosis*; D009809:Odontoid Process / Q000378:metabolism; D011241:Prednisone / Q000627:therapeutic use; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D017886:Durapatite; D011241:Prednisone; D002131:Calcium Pyrophosphate
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