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                        "tituloSerie" => "Rev Rhum Mal Osteoartic Engl Ed"
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Images in Clinical Rheumatology
Crowned Dens Syndrome: Calcification of the Transverse Ligament of the Atlas
Calcificación del ligamento transverso del atlas: síndrome de Crowned Dens
Elena Peñas Martíneza, M. José Moreno Martíneza, Carlos Marras Fernandez-Cida,
Corresponding author
cmarras2002@yahoo.es

Corresponding author.
, Begoña Torregrosa Salab
a Servicio de Reumatología, HUVA Arrixaca, Murcia, Spain
b Servicio de Radiología, HUVA Arrixaca, Murcia, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Axial skeleton affection due to chondrocalcinosis has been associated to calcium deposits in the intervertebral disc&#44; the yellow ligament&#44; the fact joints and even the sacroiliac joints&#46; Calcification of the transverse ligament of the atlas &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1&#8211;3</a>&#41; is an infrequent manifestation and has been denominated the Crown Dens syndrome&#46; It mostly constitutes an asymptomatic clinical picture but may be associated with episodes of acute cervical pain&#44; stiffness and fever&#44; with the added diagnostic difficulties of these cases&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of an 82-year-old woman who consulted us due to intense cervical pain which responded poorly to analgesics&#46; She had a history of atrial fibrillation undergoing anticoagulation therapy&#44; spondyloarthritis and radiologic chondrocalcinosis of the knees&#46; Physical examination revealed spontaneous pain on the cervical spine&#44; radiating to the occipital and mastoid regions&#44; with stiffness and movement limitations due to pain&#44; with no neurologic manifestations&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">X-ray studies show cervical spondyloarthritis and calcification of the transverse ligament of the atlas and winged ligaments of the atlas-axis joint &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The Crowned Dens syndrome was described initially in 1985 by Bouvet et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> Diagnosis is based on the association of a compatible clinical picture and imaging findings&#44; mainly calcium deposits in atlas-axis joint ligaments&#44; visible on CT&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Knowledge of this entity is important in certain cases in which it may be difficult to perform a differential diagnosis with neurological infections&#44; polymyalgia rheumatic&#44; giant cell arteritis&#44; etc&#46;</p></span>"
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                      "titulo" => "Crowned dens syndrome misdiagnosed as polymyalgia reum&#225;tica&#44; giant cell arteritis&#44; meningitis or spondylitis&#58; an an&#225;lisis of eight cases"
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ISSN: 21735743
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