Ito Kiyoshi, Aoyama Tatsuro, Hara Yosuke, Horiuchi Tetsuyoshi, Hongo Kazuhiro
Department of Neurosurgery, Shinshu University School of Medicine, Asahi, Matsumoto-city, Nagano, Japan.
No Shinkei Geka. 2011 Aug;39(8):769-72.
We report a case of pseudogout manifested by severe posterior neck pain. Pseudogout of the neck, also known as the crowned dens syndrome, causes acute neck pain characterized by calcium pyrophosphate dehydrate deposition around the odontoid process. Crowned dens syndrome is typified clinically by severe cervical pain and stiffness, often in conjunction with raised inflammatory markers. A 71-year-old man presented with severe neck pain. On admission, elevation of serum CRP level was confirmed. Magnetic resonance images showed no responsible abnormalities except for degenerating change of the spine. The patient was diagnosed as having pseudogout caused by calcium pyrophosphate dehydrate deposition based on cervical computed tomographic imaging, which showed linear calcification in the transverse ligament of the axis. After administration of non-steroidal anti-inflammatory drugs, the fever and neck pain disappeared and the CRP level returned to within the normal range. Pseudogout of the cervical spine should be considered as a differential diagnosis when we examine patients with acute neck pain. Cervical spinal computed tomographic scan is a more sensitive and useful examination method to diagnose this disease rather than magnetic resonance images.
我们报告一例以严重颈部后侧疼痛为表现的假性痛风病例。颈部假性痛风，也称为齿状突冠综合征，可导致急性颈部疼痛，其特征为齿状突周围有焦磷酸钙脱水物沉积。齿状突冠综合征的临床典型表现为严重的颈部疼痛和僵硬，常伴有炎症指标升高。一名71岁男性因严重颈部疼痛就诊。入院时，血清CRP水平升高得到证实。磁共振成像除显示脊柱退变改变外未发现其他相关异常。基于颈椎计算机断层扫描成像显示枢椎横韧带呈线性钙化，该患者被诊断为由焦磷酸钙脱水物沉积引起的假性痛风。给予非甾体抗炎药后，发热和颈部疼痛消失，CRP水平恢复至正常范围。在检查急性颈部疼痛患者时，应将颈椎假性痛风作为鉴别诊断考虑。颈椎计算机断层扫描是诊断该病比磁共振成像更敏感且更有用的检查方法。
