J Korean Soc Spine Surg.  2008 Dec;15(4):286-289. 10.4184/jkss.2008.15.4.286.

The Crowned Dens Syndrome: A Case Report

• Cha JR
• Cho SD
• Ko SH
• Jung KH
• Youm YS
• Jung JY
• Park KB
• Lee CC

• KMID: 2209634
• DOI: http://doi.org/10.4184/jkss.2008.15.4.286

Abstract

Patients with Crowned dens syndrome typically present with severe neck pain and have calcification around the axial odontoid process on radiographs. To our knowledge, Crowned dens syndrome is unreported in the Korean literature and the clinical features remain unclear. We present Crowned dens syndrome as a cause of acute cervical pain and review the literature.

Keyword

Odontoid process; calcification; Crowned dens syndrome

MeSH Terms

Crowns
Humans
Neck Pain
Odontoid Process

Figure

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  Fig. 1. (A) Anteroposterior radiographs of the cervical spine showed scoliosis of cervical spine. (B) Lateral radiographs of the cervical spine.

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  Fig. 2. Patterns of calcifications according to localization and extent in relation to the odontoid process of the axis on computed tomography scans. (A) The axial view of computed tomography scans showed multiple calcifications (0.8×1.2×1.0 cm) in right lateral aspect of odontoid process of C2. (B) The coronal view of computed tomography scans showed calcifications (0.8 ×1.2×1.0 cm) in right lateral aspect of odontoid process of C2.

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  Fig. 3. (A, B) Magnetic resonance images of a patient, showing a low-signal intensity change in right lateral aspect of odontoid process of C2.

Reference

01). Bouvet JP., Ie Parc JM., Michalski B., Benlahrache C., Anquier L. Acute neck pain due to calcifications surrounding the odontoid process: the crowned dens syndrome. Arthritis Rheum. 1985. 28:1417–1420.

02). Malca SA., Roche PH., Pellet W., Combalbert A. Crowned dens syndrome: a manifestation of hydroxyapatite rheumatism. Acta Neurochir (Wien). 1995. 135:126–130.

03). Aouba A., Vuillemin-Bodaghi V., Mutschler C., De Bandt M. Crowned dens syndrome misdiagnosed as polymyalgia rheumatica, giant cell artertitis, meningitis or spondylitis: an analysis of eight cases. Rheumatology. 2004. 43:1508–1512.

04). Wu DW., Reginato AJ., Torriani M., Robinson DR., Reginato AM. The crowned dens syndromes as a cause of neck pain: report of two new cases and review of the literature, Arthritis Rheum. 2005. 53:133–137.

05). Goto S., Umehara J., Aizawa T., Kokubun S. Crowned Dens syndrome. J Bone Joint Surg Am. 2007. 12:2732–2736.

06). Kobayashi Y., Mochida J., Saito I., Matui S., Toh E. Calcification of the alar ligament of the cervical spine: imaging findings and clinical course. Skeletal Radiol. 2001. 30:295–297.

07). Sato Y., Yasuda T., Konno S., Kuwayama A., Komatsu K. Pseudogout showing meningoencephalitic symptoms: crowned dens syndrome. Intern Med. 2004. 43:865–868.