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Cervical computed tomography dependent diagnosis of Crowned Dens Syndrome in Calcium pyrophosphate dihydrate crystal deposition disease

American Journal of Medicine Aug 02, 2019

Haikal A, et al. - A retrospective chart review of 191 patients with calcium pyrophosphate disease (CPPD) was carried out by researchers from November 1, 2005, to November 1, 2017, to evaluate the presence of Crowned Dens Syndrome (CDS) in patients with CPPD. A total of 34 patients with CDS were reported. From 191 patients with CPPD, 57 had cervical computed tomography done, out of which 34 had periodontoid calcifications. Only 12 patients were previously assessed and received diagnoses with CDS by rheumatologists; 22 were either not seen by a rheumatologist or did not receive a diagnosis of CDS. In all, 28 patients had additional sites of chondrocalcinosis on available radiographs, among whom 8 had ≥ 3 sites of chondrocalcinosis in typical CPPD locations. No radiographs were found in six patients. Therefore, in elderly patients with neck pain, CDS was concluded as an under-identified entity that should be acknowledged in the setting of CPPD. Overall, about 60% of patients with CPPD who had cervical computed tomography findings consistent with CDS was noted.

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