Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Am J Case Rep. 2024 Aug 27;25:e944684. doi: 10.12659/AJCR.944684.
BACKGROUND Crowned dens syndrome (CDS) is a rare condition characterized by deposition of calcium pyrophosphate crystals on the odontoid process of the second cervical vertebra, forming a calcified 'crown', with neck pain being a common symptom. The disorder exhibits unique clinical and radiological features, resembling manifestations of meningitis, such as acute headaches and cervical stiffness. There are few case reports and case series related to CDS. Patients generally respond well to treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), although there is a certain rate of recurrence. Since there are few reports of CDS, we sought to publish this case report, aiming of increasing clinicians' awareness and reducing misdiagnosis rates. CASE REPORT A 62-year-old man presented to the Emergency Department with "cutting-like" headaches and neck pain for 2 days, and was subsequently diagnosed with CDS by cervical computed tomography (CT) scan, and hematological tests revealed inflammatory manifestations. He was advised to take oral nonsteroidal anti-inflammatory drugs and to rest; his symptoms improved after 3 days and his neck pain had almost resolved after 2 months. CONCLUSIONS In older patients experiencing new headaches and neck pain, along with increased inflammatory markers, particularly those with a history of pseudogout, the possibility of CDS should be considered. Case reports suggest that oral NSAIDs and short courses of corticosteroids can generally alleviate symptoms. Further research is needed on CDS diagnosis and treatment.
背景 盔甲状颈椎骨密度增高综合征（CDS）是一种罕见的疾病，其特征是焦磷酸钙晶体在第二颈椎的齿状突上沉积，形成一个钙化的“冠”，颈部疼痛是常见的症状。该疾病表现出独特的临床和影像学特征，类似于脑膜炎的表现，如急性头痛和颈部僵硬。与 CDS 相关的病例报告和病例系列很少。患者通常对非甾体抗炎药（NSAIDs）治疗反应良好，尽管有一定的复发率。由于 CDS 的报告较少，我们希望发表这个病例报告，旨在提高临床医生的认识并降低误诊率。 病例报告 一名 62 岁男性因“切割样”头痛和颈部疼痛就诊于急诊科，持续 2 天，随后通过颈椎 CT 扫描诊断为 CDS，血液检查显示炎症表现。建议他口服非甾体抗炎药并休息；他的症状在 3 天后改善，2 个月后颈部疼痛几乎缓解。 结论 在出现新的头痛和颈部疼痛以及炎症标志物增加的老年患者中，特别是那些有假性痛风病史的患者，应考虑 CDS 的可能性。病例报告表明，口服 NSAIDs 和短期皮质类固醇治疗通常可以缓解症状。需要进一步研究 CDS 的诊断和治疗。
