title: [A rare cause of febrile cervical pain].
abstract: Febrile cervical pain is often secondary to meningitis or spondylodiscitis and, exceptionally, to microcrystalline arthropathy. We here report a case. A 81-year old man with no particular personal history was hospitalized with febrile cervical pain. Initial diagnoses were meningitis and spondylodiscitis. Clinical examination showed overall stiffness of cervical rachis. Spinal MRI showed abnormality of the atlanto-axial articulation signal, enhanced after gadolinium injection with synovial hypertrophy associated with irregular and heterogeneous aspect of the dens of the axis. Serial atlanto-axial Computed Tomography (CT) scan showed peri-odontoid calcifications, confirming the diagnosis of crowned dens syndrome (CDS). Patient evolution was favorable under nonsteroidal anti-inflammatory drugs (NSAIDs). CDS deserves to be better known; it can mimic many disorders and be responsible for long term fever.
authors.affiliation: Service de Rhumatologie, CHU Farhat Hached, Sousse, Tunisie.
authors.forename: Zeineb
authors.initials: Z
authors.lastname: Alaya
authors.affiliation: Service de Chirurgie orthopédique, CHU Sahloul, Sousse, Tunisie.
authors.forename: Walid
authors.initials: W
authors.lastname: Osman
authors.affiliation: Service d'Imagerie médicale, CHU Farhat Hached, Sousse, Tunisie.
authors.forename: Houneida
authors.initials: H
authors.lastname: Zaghouani
authors.affiliation: Service de Chirurgie orthopédique, CHU Sahloul, Sousse, Tunisie.
authors.forename: Nader
authors.initials: N
authors.lastname: Naouar
authors.affiliation: Service d'Imagerie médicale, CHU Farhat Hached, Sousse, Tunisie.
authors.forename: Chakib
authors.initials: C
authors.lastname: Kraiem
authors.affiliation: Service de Rhumatologie, CHU Farhat Hached, Sousse, Tunisie.
authors.forename: Elyès
authors.initials: E
authors.lastname: Bouajina
mesh_terms: D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002574:Cervical Vertebrae; D002805:Chondrocalcinosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D015299:Discitis / Q000175:diagnosis; D005334:Fever / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008581:Meningitis / Q000175:diagnosis; D019547:Neck Pain / Q000209:etiology*; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Cervical pain; cervical CT-scan; crowned dens syndrome; fever