Crowned dens syndrome

These neck CT images (A, coronal; B, sagittal; C & D, axial) of a 72-year-old male patient with CPPD demonstrate the characteristic curvilinear calcifications of the transverse ligament of the atlas (arrows) and crown-shaped calcium deposits (A) surrounding the odontoid process. Crowned dens syndrome is characterized by recurrent neck pain related to deposits of calcium hydroxyapatite or CPPD in ligaments around the odontoid process. The appearance is that of a crown or halo surrounding the odontoid process. Patients may present with severe neck pain and stiffness, fever, and elevated inflammatory markers, mimicking infection. Evidence of CPPD in other joints suggest the diagnosis of this less common manifestation of CPPD.