Crowned Dens Syndrome

An 88-year-old woman presented with a 2-month history of recurrent episodes of acute pain in her neck and knees that were associated with fevers of 38 to 39.3°C. She reported no visual symptoms, jaw claudication, morning stiffness, or pain in the upper arms or shoulders. Radiography revealed chondrocalcinosis in the knees and stippled calcifications in the pubic symphysis. Computed tomography of the neck showed curvilinear calcifications of the transverse ligament of the atlas (Panel A, arrows), a linear calcification (Panel B, arrows), and crown-shaped calcium deposits surrounding the odontoid process (Panel C, arrowheads). Crowned dens syndrome is characterized by recurrent . . .