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.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880003 | PMC |
| http://dx.doi.org/10.7759/cureus.12678 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Imaging and management of calcium pyrophosphate deposition disease.
Skeletal Radiol
January 2025
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 32 Fruit Street, Yawkey 6044, Boston, MA, 02114, USA.
The radiological manifestations of calcium pyrophosphate deposition (CPPD) revolve around two main axes: the asymptomatic form and CPPD disease. The latter is a consequence of an immune response to calcium phosphate crystals. Chondrocalcinosis is broadly considered the radiographic manifestation of CPPD regardless of whether it is asymptomatic or associated with inflammatory arthritis.
View Article and Find Full Text PDFCrowned dens syndrome: a rare differential diagnosis of meningitis.
CJEM
January 2025
Department of Emergency Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Campus Benjamin Franklin, 12203, Berlin, Germany.
A Diagnosis Fit for a Queen: Crowned Dens Syndrome.
Clin Pract Cases Emerg Med
November 2024
Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota.
Case Presentation: We describe a case of an elderly female patient with a history of pseudogout who presented to the emergency department with atraumatic neck pain, fever, and malaise, who was found to have crowned dens syndrome on computed tomography imaging.
Discussion: It is important that emergency physicians consider crowned dens syndrome in elderly patients presenting with neck pain and signs of inflammation to ensure timely diagnosis, treatment, and to minimize unnecessary invasive testing.
Double Teeth and Coexistent Anomalies: Examples From Continental Africa.
Am J Hum Biol
November 2024
Research Centre in Evolutionary Anthropology and Palaeoecology, School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK.
Objectives: Whether gemination or fusion, double teeth are rare worldwide, including Africa based on few published data. New cases from the continent are tallied, and anomalies potentially associated with double teeth are identified. These findings should interest a range of dental researchers.
View Article and Find Full Text PDFAcute Neck Pain from Crowned Dens Syndrome: A Case Report and Clinical Insights.
Am J Case Rep
August 2024
Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!