Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Crowned Dens Syndrome as an Initial Manifestation of Crystalline Deposition Disease
Ryo Koda, Yohei Tsuchida, Kazutaka Yoshizawa, Kazuo Suzuki, Akio Kasai, Tetsuro Takeda, Junichiro James Kazama, Ichiei Narita, Kazukiyo Yoshida
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Keywords: crowned dens syndrome, crystalline deposition disease, nonsteroidal anti-inflammatory drugs
JOURNAL OPEN ACCESS

2015 Volume 54 Issue 18 Pages 2405-2408

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Abstract

An 88-year-old woman presented with fever and acute posterior neck pain. A CT scan revealed calcification of the transverse ligament and crown-like calcification around the odontoid process. According to the clinical and radiological findings, she was diagnosed with crowned dens syndrome (CDS). Her symptoms drastically improved following treatment with oral nonsteroidal anti-inflammatory medication. An X-ray of her wrist, elbow, shoulder and knee joints showed asymptomatic calcium deposits, suggesting underlying crystalline deposition disease. CDS may occur as the initial presentation of crystalline deposition disease. The measurement of procalcitonin and an X-ray survey of the major joints may be helpful for the diagnosis of CDS.

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© 2015 by The Japanese Society of Internal Medicine
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