Comorbidity Between Crowned Dens Syndrome and Primary Hyperparathyroidism

Area of Science:

• Endocrinology
• Rheumatology
• Orthopedics

Background:

• Primary hyperparathyroidism (PHPT) is a condition often presenting with non-specific symptoms like malaise, psychiatric issues, and hypertension.
• Hypercalcemia associated with PHPT can manifest as pathological fractures or lethargy.
• PHPT is increasingly recognized as a potential complication of crowned dens syndrome (CDS).

Observation:

• A 72-year-old female presented with progressive low back pain, leading to immobility.
• Initial symptoms suggested a musculoskeletal issue, but further investigation was warranted.

Findings:

• The patient was diagnosed with PHPT complicated by CDS based on comprehensive imaging, blood tests, and clinical evaluation.
• The case highlights the complex interplay between metabolic bone disease and spinal inflammatory conditions.

Implications:

• A thorough physical examination of the neck and cervical spine CT are recommended for PHPT patients.
• Measuring calcium levels in patients diagnosed with CDS may facilitate the early detection of underlying PHPT.
• This case underscores the importance of considering systemic conditions in patients presenting with seemingly localized symptoms.