Crowned Dens Syndrome: Calcium Pyrophosphate Deposition Disease Masquerading as Osteomyelitis

Crowned dens syndrome (CDS) is a clinical and radiological entity consisting of acute neck pain, accompanied by specific radiographic findings of calcifications from calcium pyrophosphate dihydrate crystals superior to and surrounding the dens of the axis, resulting in a “crown-like” appearance on coronal views1. A 76-year-old female presented from an outside hospital for concern of osteomyelitis, with persistent neck pain following treatment for Escherichia coli sepsis. She had mild tenderness to palpation but intense pain …