Acute neck pain due to calcifications surrounding the odontoid process: The crowned dens syndrome
✍ Scribed by Dr. Jean-Pierre Bouvet; Jean-Marie Le Parc; Bernard Michalski; Charif Benlahrache; Louis Auquier
- Publisher
- John Wiley and Sons
- Year
- 1985
- Tongue
- English
- Weight
- 483 KB
- Volume
- 28
- Category
- Article
- ISSN
- 0004-3591
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✦ Synopsis
Crystal-induced neck pain sometimes occurs in patients who have hydroxyapatite (HA) or calcium pyrophosphate dihydrate (CPPD) crystal deposition diseases. Cervical HA deposits involve the longus colli muscle tendon (1-6) or the intervertebral disc (7), whereas CPPD deposits are located in the interverte-bra1 lclisc (7), the ligamentum flavum ( 8), the apophyse-a1 joints, and probably the traosverse ligament (9). In a previous report, we described a new location of deposits in a patient who had HA crystal disease (10). These deposits provoked severe pain in the upper cerviical region and, on frontal view radiographs, appeared as a crown-like density surrounding the odontoid process. We describe here 4 additional patients having calcifications similar to those of the patient we previously described, but who had various types of calcium deposition diseases.
Case reports. Patient I , a 59-year-old woman, was first examined in March 1980 for severe pain and rigidity in the upper neck. Tomographic examination showed a large calcification surrounding the top of the odontoid process (Figure IA). She was treated with indomethacin, and her symptoms disappeared within 3 weeks. In April 1984, she was again seen for chronic From the