Crowned dens syndrome: a case report

Clinical syndromes may be associated with deposition of calcium pyrophosphate crystals dihydrate (CPP) in connective tissues. Crowned dens syndrome (CDS) is a rare presentation involving the presence of CPP around the atlantoaxial joint, which is characterized by acute or recurrent severe cervical pain, neck rigidity, and associated fever, in addition to increased inflammatory markers. Identifying CPPs by computed tomography (CT) is essential to exclude the differential diagnosis, such as polymyalgia rheumatica, giant cell arteritis or, less frequently, meningitis, cervical dyscitis or inflammatory spondyloarthritis We present a case report of a male with recurrent cervical pain irradiated to the shoulder and upper limbs, with reduced cervical mobility, whose MRI indicated CDS.