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Case Reports
. 2015 Aug 12;3(2):155-158.
doi: 10.1002/ams2.147. eCollection 2016 Apr.

Crowned dens syndrome: reports of six cases and review of the literature

Kosuke Tajima  1 , Tomoko Ueda  1 , Koichi Ueno  1 , Chikako Shimizu  1 , Joe Yoshizawa  1 , Shingo Hori  1
Affiliations
Case Reports

Crowned dens syndrome: reports of six cases and review of the literature

Kosuke Tajima et al. Acute Med Surg. .

Abstract

Case: We have reported six cases of Crowned dens syndrome (CDS) diagnosed by computed tomography (CT). Presenting cases were three male and three female, aged from 45 to 89 (averaged in 72).

Outcome: All cases showed calcification around the dens of axis in CTs. Neck pain in all cases relieved within at least 10 days, treated by non-steroidal anti-inflammatory drugs (NSAIDs) in five cases, and one by acetaminophens.

Conclusion: Bouvet et al. first reported CDS in 1985, as acute pseudogout of the neck, which causes neck pain. CDS is a radioclinical syndrome defined by the radiographic calcifications in a crown-like configuration around the odontoid process, accompanied clinically by acute neck pain, often with neck stiffness, fevers and raised inflammatory markers. CDS is thought to be a rare condition; however, it is frequently misdiagnosed. CDS is an important differential diagnosis in patients presenting with acute neck pain.

Keywords: Calcium pyrophosphate dehydrate; crowned dens syndrome; neck pain; odontoid process; pseudogout.

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Figures

Figure 1
Figure 1
Axial (a) and sagittal (b) computed tomography (CT) views demonstrating calcification posterior to the odontoid process.
Figure 2
Figure 2
Axial computed tomography (CT) views (a) demonstrating calcification posterior to the odontoid process. (b) Enlarged view.
See this image and copyright information in PMC

References

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