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Crowned dens syndrome. A case report.

Anna Koyfman1, Daniel Yaffe2

  • 1Department of Radiology, Meir Medical Center; Kfar Saba, Israel - zelenenkayaa@mail.ru.

The Neuroradiology Journal
|September 9, 2014
PubMed
Summary

Crowned dens syndrome, a rare cause of neck pain from crystal deposition, is often missed. Early diagnosis via cervical CT scan prevents misdiagnosis and unnecessary treatments, leading to rapid recovery.

Keywords:
acute headachealar ligamentcalcium depositscrowned dens syndrome

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Area of Science:

  • Rheumatology
  • Radiology
  • Neurology

Background:

  • Crystal deposition in the cervical spine, particularly around the odontoid process, can cause acute neck pain.
  • This condition, known as crowned dens syndrome, is a rare but important consideration in diagnosing unexplained fever, headache, and cervical pain.

Observation:

  • The syndrome is frequently overlooked, leading to misdiagnosis, invasive procedures, and inappropriate treatments.
  • Accurate diagnosis relies on imaging, specifically a cervical CT scan, which can identify calcium deposits in the alar ligament.

Findings:

  • The case study describes a patient presenting with acute occipital headache and radiographic evidence of calcium deposits in the alar ligament, consistent with crowned dens syndrome.
  • The patient experienced a rapid recovery within four days with symptomatic therapy.

Implications:

  • Early recognition and diagnosis of crowned dens syndrome through cervical CT scans can prevent misdiagnosis and unnecessary interventions.
  • Prompt diagnosis and management lead to a good prognosis, with symptoms typically resolving within weeks.