Crowned Dens Syndrome Incidentally Diagnosed After Investigation of Cervical Spine Injury With Incomplete Quadriplegia: A Case Report and Review of the Literature

Abstract

Crowned dens syndrome (CDS) is a rare clinical entity characterized by acute neck pain due to calcification around the odontoid process of the axis in "crown-like" configuration. The disease can cause neurological symptoms, due to spinal cord compression but also it may lead to chronic neck pain or be asymptomatic. We present a case of a 73-year-old patient who, after a fall of a height of approximately 2 m, sustained a cervical spine injury and his clinical examination revealed an incomplete quadriplegia. Surprisingly, the only finding after the diagnostic imaging, including radiographs, CT scan and MRI, was periodontoid calcification, indicative of CDS. After a few days of hospital admission, a full neurological recovery was spontaneously achieved and the patient, after a 6-week use of cervical orthosis, was free of pain. We perform a brief review of the literature to shed light onto this rare clinical entity.

Crowned Dens Syndrome as a cause of acute neck pain: a Case Report and Review of the Literature

“…7 Patients typically present with acute severe neck pain, with concomitant neck stiffness, often with significant restriction of cervical rotation, and possibly fever, while the inflammatory markers are often elevated. 9 It may be detected in up to 5% of patients over the age of 70 who present to hospital with neck pain. 7 The syndrome may cause chronic neck pain or even spinal cord compression.…”