Crowned Dens Syndrome in a Patient with Pseudogout

 

Clinical features:

(1) acute neck pain with or without stiffness

(2) fever and elevated ESR

(3) imaging studies showing calcifications surrounding the odontoid process ("crown"), often with deposits elsewhere in the cervical spine

(4) presence of calcium pyrophosphate dihyrate crystals (may be identified in other joints)

(5) variable headache

(6) often associated with arthritis in another joint

 

Complications:

(1) cervical cord compression

 

Differential diagnosis:

(1) meningoencephalitis

(2) giant cell arteritis