[Acute, hyperintense, and febrile cervicalgia. Crowned dens syndrome, a monofocal microcrystalline arthritis sometimes doubly misleading]
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Updated: Jun 20, 2026

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
T Weitten1, R Mourot, J Durckel
1Service de médecine interne, clinique médicale B, CHRU de Strasbourg, porte de l'Hôpital, Strasbourg, France.
Abstract:
Microcrystalline arthritis sometimes have atypical localizations and presentations. The crowned dens syndrome, due to hydroxyapatite or calcium pyrophosphate deposits in peri-odontoid ligaments of the atlas, can provoke acute or chronic cervicalgia or misleading presentations such as meningitidis or fever of unknown origin. We present a particularly severe new case requesting urgent surgery, and a literature review to alert clinicians and prevent misdiagnosing this syndrome. Indeed, calcifications may be very discrete or just incidental and prevent a complete diagnostic approach.
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