Crowned dens

Case contributed by Dr Domenico Nicoletti

Presentation

Seventy year old female reports two weeks of pain and neck stiffness with low grade fever and increased inflammatory markers.

Patient Data

Age: 70 years
Gender: Female
CT

There are granular calcifications arranged in a "crown" like fashion aroudn the dens and in the transverse ligament. The neural tube is normal.

There is severe facet arthrosis on the left. 

Annotated image

There are granular calcifications arranged in a "crown" like fashion around the dens and in the transverse ligament. 

Case Discussion

Acute onset of cervical pain associated with elevation of inflammatory indicators and/or signs of cervical myelopathy should suggest a CT scan searching for microcrystal deposition in the periodontoid tissue, known as crowned dens syndrome

This is most often associated with CPPD disease or HADD

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Case information

rID: 36711
Published: 12th Aug 2015
Last edited: 9th Oct 2019
Inclusion in quiz mode: Included

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