Advertisement

Rheumatology International

, Volume 31, Issue 1, pp 85–88 | Cite as

Acute pseudogout of the neck—the crowned dens syndrome: 2 case reports and review of the literature

  • Keith Siau
  • Martin Lee
  • Catherine J. LaversuchEmail author
Case Report

Abstract

Acute pseudogout of the neck, also known as the crowned dens syndrome, is a rare cause of neck pain characterised by crystalline deposition in periodontoid articular tissues. It is typified clinically by severe cervical pain and stiffness, often in conjunction with pyrexia and raised inflammatory markers. As such, it is often misdiagnosed. We report 2 cases of crowned dens syndrome masquerading respectively as meningitis and polymyalgia rheumatica, and review the literature with particular attention to the clinical and radiological aspects of this under-recognised condition.

Keywords

Pseudogout Crowned dens syndrome CDS 

Notes

Conflict of interest statement

The authors declare no conflicts of interest.

References

  1. 1.
    Bouvet JP, le Parc JM, Michalskib B et al (1985) Acute neck pain due to calcifications surrounding the odontoid process: the crowned dens syndrome. Arthritis Rheum 28(12):1417–1420CrossRefPubMedGoogle Scholar
  2. 2.
    Goto S, Umehara J, Aizawa T et al (2007) Crowned dens syndrome. J Bone Joint Surg Am 89:2732–2736CrossRefPubMedGoogle Scholar
  3. 3.
    Richette P, Bardin T, Doherty M (2009) An update on the epidemiology of calcium pyrophosphate dihydrate crystal deposition disease. Rheumatology 48(7):711–715CrossRefPubMedGoogle Scholar
  4. 4.
    Steinbach LS, Resnick D (1996) Calcium pyrophosphate dehydrate crystal deposition disease revisited. Radiology 200:1–9PubMedGoogle Scholar
  5. 5.
    Finckh A, Van Linthoudt D, Duvoisin B et al (2004) The cervical spine in calcium pyrophosphate dihydrate deposition disease. A prevalent case–control study. J Rheumatol 31(3):545–549PubMedGoogle Scholar
  6. 6.
    Aouba A, Vuillemin-Bodaghi V, Mutschler C, De Bandt M (2004) Crowned dens syndrome misdiagnosed as polymyalgia rheumatica, giant cell arteritis, meningitis or spondylitis: an analysis of eight cases. Rheumatology 43(12):1508–1512CrossRefPubMedGoogle Scholar
  7. 7.
    Fye KH, Weinstein PR, Donald F (1999) Compressive cervical myelopathy due to calcium pyrophosphate dihydrate deposition disease: report of a case and review of the literature. Arch Intern Med 159:189–193CrossRefPubMedGoogle Scholar
  8. 8.
    Wu DW, Reginato AJ, Torriani M et al (2005) The crowned dens syndrome as a cause of neck pain: report of two new cases and review of the literature. Arthritis Rheum 53(1):133–137CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Keith Siau
    • 1
  • Martin Lee
    • 2
  • Catherine J. Laversuch
    • 1
    Email author
  1. 1.Department of RheumatologyMusgrove Park HospitalTauntonUK
  2. 2.Department of RheumatologyRoyal Cornwall HospitalTruroUK

Personalised recommendations