title: Crowned Dens Syndrome as an Initial Manifestation of Crystalline Deposition Disease.
abstract: An 88-year-old woman presented with fever and acute posterior neck pain. A CT scan revealed calcification of the transverse ligament and crown-like calcification around the odontoid process. According to the clinical and radiological findings, she was diagnosed with crowned dens syndrome (CDS). Her symptoms drastically improved following treatment with oral nonsteroidal anti-inflammatory medication. An X-ray of her wrist, elbow, shoulder and knee joints showed asymptomatic calcium deposits, suggesting underlying crystalline deposition disease. CDS may occur as the initial presentation of crystalline deposition disease. The measurement of procalcitonin and an X-ray survey of the major joints may be helpful for the diagnosis of CDS.
authors.affiliation: Niigata Prefectural Muikamachi Hospital, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Koda
authors.forename: Yohei
authors.initials: Y
authors.lastname: Tsuchida
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Yoshizawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Suzuki
authors.forename: Akio
authors.initials: A
authors.lastname: Kasai
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Takeda
authors.forename: Junichiro James
authors.initials: JJ
authors.lastname: Kazama
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.forename: Kazukiyo
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001175:Arthrography; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D019547:Neck Pain / Q000209:etiology; D009809:Odontoid Process / Q000000981:diagnostic imaging*; D013577:Syndrome; D014057:Tomography, X-Ray Computed
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal