A case of crowned dens syndrome in a 4-year-old girl

Abstract

Crowned dens syndrome (CDS) is defined as the presence of severe neck pain and calcifications around and above the odontoid process of the axis, and occurs frequently in elderly women. We report the first case of CDS in children. A 4-year-old girl presented to our hospital with neck pain and fever. She was diagnosed as having CDS after cervical computed tomography (CT) showed calcifications around the dens. Her symptoms improved spontaneously with use of nonsteroidal anti-inflammatories and bed rest. Cervical CT revealed disappearance of circumferential calcification of the dens without treatment, 14 months after onset. We conclude that CDS should be considered in the differential diagnosis, even in children presenting with severe neck pain and fever, and a cervical CT scan should be obtained.