<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background</bold>. 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).<bold>Case report</bold>. 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.<bold>Conclusions</bold>. 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.</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 presenting as pyrexia of unknown origin (PUO)

Romanian Journal of Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

{"article-title":"Crowned dens syndrome presenting as pyrexia of unknown origin (PUO)"}

Background. Deposition of calcium pyrophosphate crystals in the cervical spine around the odontoid process may lead to neck pain and fever. This condition is...

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

Published Online: Sep 09, 2019

Page range: 266 - 269

Received: Apr 16, 2019

DOI: https://doi.org/10.2478/rjim-2019-0011

Keywords
crowned dens syndrome, fever, elderly

© 2019 Agam Bansal et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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

Published Online: Sep 09, 2019

Page range: 266 - 269

Received: Apr 16, 2019

DOI: https://doi.org/10.2478/rjim-2019-0011

Keywordscrowned dens syndrome, fever, elderly

© 2019 Agam Bansal et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
crowned dens syndrome, fever, elderly