scholarly journals Crowned dens syndrome

2012 ◽  
Author(s):  
Norma Belfiore ◽  
Vito Privitera ◽  
Giampaolo Carmosino ◽  
Giulio Doveri
Keyword(s):  
Neck Pain ◽  
Odontoid Process ◽  
Unknown Origin ◽  
The Elderly ◽  
Calcium Pyrophosphate ◽  
Acute Onset ◽  
Cervical Pain ◽  
Calcium Pyrophosphate Dehydrate ◽  
Crowned Dens Syndrome ◽  
Inflammatory Drugs

Introduction Microcrystalline deposition in peri-odontoid articular structures is mainly responsible for acute or chronic cervical pain and is known as “crowned dens syndrome”.Materials and methods We described two cases of acute cervical pain associated with onset of fever and peripheral acute monoarthritis. Cervical computed tomography (CT) scan showed linear calcification of the retrodens ligament and calcium pyrophosphate dehydrate (CPPD) crystals were found in synovial fluid of inflamed joints. Both patients were treated with anti-inflammatory drugs and colchicine.Discussion Calcium depositions around the odontoid process of the axis can be occasionally detected by radiological studies. They are frequently asymptomatic but sometimes can be associated with severe neurological abnormalities, fever and acute neck pain. CPPD crystals are usually deposited in joints and bursae but occasionally can disrupt these anatomical confines and deposit in periarticular tissues, sometimes forming large masses confused with tumours.Conclusions Acute onset of cervical neck pain associated with elevation of inflammatory indicators and/or signs of cervical myelopathy should suggest CT scans searching for microcrystal depositions in the peryodonthoid tissue. Differential diagnosis of fever of unknown origin (FUO) should include crowned dens syndrome specially in the elderly after exclusion of several endocrine or metabolic disorders, infection diseases (meningitis), arthritis (psoriatic arthritis and ankylosing spondylitis) and tumours (chordoma, meningioma, osteoblastoma).

scholarly journals Crowned Dens Syndrome Occurring after Endoscopic Submucosal Dissection for Early Gastric Cancer

2021 ◽  
pp. 22-27
Author(s):  
Takeshi Okamoto ◽  
Takashi Ikeya ◽  
Katsuyuki Fukuda
Keyword(s):  
Gastric Cancer ◽  
Neck Pain ◽  
Endoscopic Submucosal Dissection ◽  
Odontoid Process ◽  
Calcium Pyrophosphate ◽  
Endoscopic Procedures ◽  
Submucosal Dissection ◽  
Calcium Pyrophosphate Dehydrate ◽  
Crowned Dens Syndrome ◽  
Head Computed Tomography

Crowned dens syndrome (CDS) is a rare form of pseudogout which causes acute neck pain due to calcium pyrophosphate dehydrate deposition surrounding the odontoid process, commonly causing neck pain with rigidity. While invasive procedures such as surgery are known to present a risk of acute pseudogout, reports of occurrence after endoscopic procedures are scarce. We report the case of a 75-year-old man who presented with sudden neck pain after endoscopic submucosal dissection (ESD) for gastric cancer. He could nod but could not rotate his head. Computed tomography showed calcifications surrounding the odontoid process consistent with CDS. Prolonged dietary restrictions and proton pump inhibitor use following the ESD procedure may have caused hypomagnesemia, a precipitating factor for CDS. We prescribed colchicine 1 mg/day and symptoms resolved completely in 3 days. This is the first report of CDS after ESD. CDS should be included in the differential diagnosis of neck pain after endoscopic procedures.

Síndrome de la apófisis odontoides coronada, una manifestación inusual de dolor cervical. Presentación de un caso

2020 ◽  
Vol 63 (3) ◽  
pp. 23-25
Author(s):  
Pedro Pablo González Rojas ◽  
Jonathan Restrepo Pérez Restrepo ◽  
Juan Felipe Mantilla Hernández
Keyword(s):  
Odontoid Process ◽  
Clinical History ◽  
Calcium Pyrophosphate ◽  
Cervical Pain ◽  
Crystal Deposition ◽  
Crystal Deposition Disease ◽  
Calcium Pyrophosphate Dehydrate ◽  
Deposition Disease ◽  
Crowned Dens Syndrome ◽  
Unnecessary Procedures

The calcium pyrophosphate dehydrate (CPPD) or hydroxyapatite (HA) crystal deposition disease can appear in any joint and the accumulation fo crystals in the cervical spine may be painful. Crowned dens syndrome is a rare clinical condition that involves crown-like calcification of the ligaments around the odontoid process. A 70-year-old man presented cervical pain, fever and a headache for over a week, therefore, a neurological condition was suspected. A CT scan revealed lentiform calcifications of the transverse ligament of the atlas. Steroid treatment and a non-steroidal anti-inflammatory diminished the symptoms. A proper clinical history and imaging studies avoid unnecessary procedures and makes it possible to include this entity as a differential diagnosis in acute cervical pain. Key words: Crystal deposition disease; acute cervical pain; crowned dens syndrome; Odontoid process

scholarly journals Crowned dens syndrome presenting as pyrexia of unknown origin (PUO)

2019 ◽  
Vol 57 (3) ◽  
pp. 266-269
Author(s):  
Agam Bansal ◽  
Mohit Gupta
Keyword(s):  
Elderly Patient ◽  
Neck Pain ◽  
Clinical Presentation ◽  
Odontoid Process ◽  
Unknown Origin ◽  
Calcium Pyrophosphate ◽  
X Ray ◽  
Recent Onset ◽  
Pyrexia Of Unknown Origin ◽  
Crowned Dens Syndrome

Abstract Background. Deposition of calcium pyrophosphate crystals in the cervical spine around the odontoid process may lead to neck pain and fever. This condition is called crowned dens syndrome (CDS). Case report. An 89-year-old female presented with complaints of fever for one-month duration and recent onset neck pain. During her admission, she developed right knee pain with evidence of chondrocalcinosis on X-ray. Considering her clinical presentation in setting of pseudogout, she had a CT scan of her neck that revealed erosion of the dens and hyperdense soft tissue surrounding the odontoid process. Based on her clinical and radiologic presentation, she was diagnosed with crowned dens syndrome and started on NSAIDs. Unfortunately, she did not respond to NSAIDs and was switched to Colchicine, which resulted in immediate improvement in her symptoms. Conclusions. We present this case to stress the importance of keeping crowned dens syndrome as one of the differentials in an elderly patient presenting with fever and neck pain.

Crowned dens syndrome

2017 ◽  
Vol 18 (1) ◽  
pp. 57-59 ◽  
Author(s):  
David Ledingham ◽  
Cecilia Cappelen-Smith ◽  
Dennis Cordato
Keyword(s):  
Inflammatory Response ◽  
Neck Pain ◽  
Polymyalgia Rheumatica ◽  
Calcium Pyrophosphate ◽  
Occipital Neuralgia ◽  
Rare Presentation ◽  
Neck Stiffness ◽  
Calcium Pyrophosphate Deposition Disease ◽  
Crowned Dens Syndrome ◽  
Treatable Condition

Crowned dens syndrome is a rare presentation of calcium pyrophosphate deposition disease. It is characterised by severe occipital pain and neck stiffness. Acute presentations are typically accompanied by fever and an inflammatory response and hence can be misdiagnosed as polymyalgia rheumatica or meningitis. Chronic relapsing presentations may be misdiagnosed as cervicogenic neck pain or occipital neuralgia. We present a patient who presented with a chronic relapsing form of crowned dens syndrome and discuss the epidemiology, typical presentation and management of this eminently treatable condition.

scholarly journals Periodontoid pseudotumoral lesions

2021 ◽  
Vol 12 ◽  
pp. 403
Author(s):  
Andrew Vinícius de Souza Batista ◽  
Guilherme Brasileiro de Aguiar ◽  
Priscilla Bennett ◽  
José Carlos Esteves Veiga
Keyword(s):  
Neck Pain ◽  
Surgical Management ◽  
Odontoid Process ◽  
The Other ◽  
Atlantoaxial Instability ◽  
Cervical Pain ◽  
Case Description ◽  
Full Resolution ◽  
Different Types ◽  
Neurologically Intact

Background: Periodontoid pseudotumoral lesions (PPL) are an uncommon cause of cervical pain and myelopathy. In addition, they may be associated with atlantoaxial instability (AAI). Case Description: Two patients over 60 years of age presented with neck pain alone. Their MR scans showed expansive lesions involving the odontoid process. One patient with AAI required an occipitocervical arthrodesis, while the other patient without instability was managed with an external orthosis (Philadelphia collar). Both of them experienced full resolution of pain and remained neurologically intact an average 36 months later (range 24–48). Conclusion: Here, we discussed the clinical, MR, and non-surgical (without AAI) versus surgical management (with AAI) for different types of PPL.

scholarly journals Acute neck pain due to calcifications surrounding the odontoid process: The crowned dens syndrome

1985 ◽  
Vol 28 (12) ◽  
pp. 1417-1420 ◽  
Author(s):  
Jean-Pierre Bouvet ◽  
Jean-Marie Le Parc ◽  
Bernard Michalski ◽  
Charif Benlahrache ◽  
Louis Auquier
Keyword(s):  
Neck Pain ◽  
Odontoid Process ◽  
Crowned Dens Syndrome ◽  
Acute Neck Pain

scholarly journals Acute Neck Pain caused by Calcium Pyrophosphate Dehydrate Deposition in the Transverse Ligament of the Atlas Case Report

2011 ◽  
Vol 25 (2) ◽  
pp. 212-213
Author(s):  
Kiyoshi Ito ◽  
Tatsuro Aoyama ◽  
Yosuke Hara ◽  
Tetsuyoshi Horiuchi ◽  
Kazuhiro Hongo
Keyword(s):  
Case Report ◽  
Neck Pain ◽  
Calcium Pyrophosphate ◽  
Transverse Ligament ◽  
Calcium Pyrophosphate Dehydrate ◽  
Acute Neck Pain

scholarly journals Calcium Pyrophosphate Deposition Disease in the Craniovertebral Junction: An Unusual Cause of Neck Pain

2021 ◽  
Author(s):  
Nestor Barreto-Neto ◽  
Edgard Torres dos Reis-Neto ◽  
Murillo Dório ◽  
Ricardo Fuller ◽  
Marcelo de Medeiros Pinheiro ◽  
...  
Keyword(s):  
Neck Pain ◽  
Radiological Finding ◽  
Odontoid Process ◽  
Craniovertebral Junction ◽  
Calcium Pyrophosphate ◽  
Cervical Spine Fracture ◽  
Atlantoaxial Joint ◽  
Acute Phase Reactants ◽  
Calcium Pyrophosphate Deposition Disease ◽  
Rare Manifestation

Crowned Dens Syndrome (CDS) is a rare manifestation of Calcium Pyrophosphate Deposition (CPPD) disease characterised by calcification around the odontoid process in the atlantoaxial joint. It manifests as intense neck pain with signs of systemic inflammation, including elevated acute phase reactants. Thus, it can simulate other causes of neck pain and diagnosis can be challenging. Moreover, CPPD disease can be asymptomatic and observed as radiological finding. Here in, two cases of spinal CPPD disease with distinct presentations are reported. The first of 83-year-old woman describes CDS that was misdiagnosed as Polymyalgia Rheumatica (PMR) whereas in the second case of 70-year-old female calcification around the odontoid process was incidentally found in a patient with acute cervical spine fracture. These two reported cases highlight the spectrum of manifestations of spinal CPPD disease and support the notion that careful discrimination of the cause of neck pain is essential for improving outcomes.

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