Crowned Dens Syndrome Associated with Hyperuricemia.

A 71-year-old man presented to the hospital clinic with a 1-day history of cervical pain. He had been treated for hyperuricemia for the past 30 years. He had a very limited cervical range of motion because of the pain, but there was no redness, warmth, or swelling of the neck. The laboratory data revealed a C-reactive protein level of 2.15 mg/dL and uric acid level of 11.4 mg/dL. Cervical computed tomography demonstrated calcification of the transverse ligament of the atlas (Picture, yellow arrowhead), and he was diagnosed with crowned dens syndrome. This is a rare disease characterized by the presence of calcification on the dens (1). Chondroid cells in the transverse ligament around the odontoid process cause the disease (2). The risk factors of this disease include age, joint trauma, serious illness, hemochromatosis, electrolyte abnormalities, and endocrine disorders. Treatment was initiated with an oral non-steroidal anti-inflammatory drug. On day 8, his symptoms of cervical pain disappeared.

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The authors state that they have no Conflict of Interest (COI).