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An Uncommon Presentation of Crowned Dens Syndrome Without Systemic Inflammation
Pavan Sakhamuru1, Manav Nayeni1, Ryan Nazari1
1College of Osteopathic Medicine, Kansas City University, Kansas City, USA.
Cureus
|June 26, 2025
Summary
Crowned Dens Syndrome (CDS), a rare condition involving crystal deposits in the cervical spine, can mimic other neck pain causes. Early diagnosis via CT imaging and conservative treatment offer effective symptom relief.
Area of Science:
- Rheumatology
- Orthopedics
- Radiology
Background:
- Crowned Dens Syndrome (CDS) is a rare condition characterized by calcium pyrophosphate dihydrate (CPPD) crystal deposition around the odontoid process.
- It often presents with symptoms overlapping common conditions like rheumatoid arthritis, meningitis, or cervical spondylosis, complicating diagnosis.
Observation:
- A case report details a 74-year-old male with chronic neck pain and limited motion.
- Advanced imaging (CT) revealed characteristic calcifications, pannus formation, and erosive changes at the C1-C2 articulation, indicative of CDS.
Findings:
- Clinical evaluation confirmed CPPD-related CDS.
- The patient experienced significant symptomatic improvement with conservative management, including NSAIDs and physical therapy.
Implications:
- CT imaging is crucial for diagnosing CDS and differentiating it from other cervical spine pathologies.
- High awareness and early diagnosis are vital for appropriate management, with conservative approaches being effective for most patients.
- Further research is needed for refractory CDS cases.
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