Crowned Dens Syndrome

Abstract

Crystal deposition in the cervical spine around the odontoid process may lead to acute neck pain. This rare condition is called crowned dens syndrome and should be considered in the differential diagnosis of a possible etiology for fever, headache and cervical pain of unknown origin. The syndrome is often overlooked, thus leading to misdiagnosis, invasive and useless investigations (lumbar puncture, biopsy), inappropriate treatment (steroids, antibiotics, antiviral drugs) and prolonged hospitalization. This can be prevented by imaging, based on a cervical CT scan that allows an accurate diagnosis. The disease has a good prognosis and symptoms usually subside within a few weeks. We describe a patient with crowned dens syndrome which manifested with clinical (acute occipital headache) and radiographic (calcium deposits in the alar ligament) features. Our patient recovered in four days with symptomatic therapy.