An 87-year-old woman with corticosteroid-resistant polymyalgia rheumatica underwent ¹⁸F-FDG PET/CT for suspected giant cell arteritis or neoplastic disease. FDG uptake in the immediate vicinity of the odontoid process, with a crownlike calcification, was identified on the CT scan on the posterior side of the dens, thus confirming the diagnosis of crowned dens syndrome. Because this rare syndrome is frequently misdiagnosed, nuclear physicians should be aware of the signs and symptoms of this condition, which may call for the use of PET/CT imagery.
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Article Synopsis
- Crowned dens syndrome (CDS) is a rare condition where calcium pyrophosphate crystals form a calcified 'crown' on the second cervical vertebra, leading to neck pain and symptoms similar to meningitis.
- A case report details a 62-year-old man who experienced severe headaches and neck pain, ultimately diagnosed with CDS through CT scan, and responded well to treatment with NSAIDs.
- The report emphasizes the need for increased awareness of CDS among clinicians to reduce misdiagnosis, especially in older patients with new neck pain and a history of pseudogout, and calls for further research on its diagnosis and treatment.
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