Bamgboje Abayomi O, Mohandas Nirupa
Internal Medicine, New York City Health + Hospitals/Metropolitan, New York, USA.
Internal Medicine/Rheumatology, New York City Health + Hospitals/Metropolitan, New York, USA.
Cureus. 2021 Jan 13;13(1):e12678. doi: 10.7759/cureus.12678.
The classic symptoms of meningismus, including fever, neck stiffness, and headache, should automatically trigger a prime differential of meningitis, but a close masquerader, albeit rare, is crowned dens syndrome. Herein, we report the case of a 71-year-old woman with clinical features of meningismus with elevated inflammatory biomarkers. However, computed tomography of the cervical spine revealed the presence of calcium deposits encircling the dens. Hence, an alternate diagnosis of crowned dens syndrome was considered. This was confirmed by the presence of similar pathology in other joints and the dramatic resolution of symptoms and inflammatory markers with the administration of nonsteroidal anti-inflammatory drugs.
脑膜刺激征的典型症状，包括发热、颈部僵硬和头痛，应自动引发对脑膜炎的主要鉴别诊断，但有一种虽罕见但酷似的病症是齿状突综合征。在此，我们报告一例71岁女性病例，其具有脑膜刺激征的临床特征且炎症生物标志物升高。然而，颈椎计算机断层扫描显示齿状突周围存在钙沉积。因此，考虑为齿状突综合征的另一种诊断。其他关节存在类似病变以及使用非甾体抗炎药后症状和炎症标志物显著缓解证实了这一诊断。
