{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:16:51Z","timestamp":1793085411008,"version":"4.5.0"},"reference-count":10,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2019,9,1]],"date-time":"2019-09-01T00:00:00Z","timestamp":1567296000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background<\/jats:bold>\n                    . Deposition of calcium pyrophosphate crystals in the cervical spine around the odontoid process may lead to neck pain and fever. This condition is called crowned dens syndrome (CDS).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case report<\/jats:bold>\n                    . An 89-year-old female presented with complaints of fever for one-month duration and recent onset neck pain. During her admission, she developed right knee pain with evidence of chondrocalcinosis on X-ray. Considering her clinical presentation in setting of pseudogout, she had a CT scan of her neck that revealed erosion of the dens and hyperdense soft tissue surrounding the odontoid process. Based on her clinical and radiologic presentation, she was diagnosed with crowned dens syndrome and started on NSAIDs. Unfortunately, she did not respond to NSAIDs and was switched to Colchicine, which resulted in immediate improvement in her symptoms.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    . We present this case to stress the importance of keeping crowned dens syndrome as one of the differentials in an elderly patient presenting with fever and neck pain.\n                  <\/jats:p>","DOI":"10.2478\/rjim-2019-0011","type":"journal-article","created":{"date-parts":[[2019,5,10]],"date-time":"2019-05-10T05:03:39Z","timestamp":1557464619000},"page":"266-269","source":"Crossref","is-referenced-by-count":3,"title":["Crowned dens syndrome presenting as pyrexia of unknown origin (PUO)"],"prefix":"10.2478","volume":"57","author":[{"given":"Agam","family":"Bansal","sequence":"first","affiliation":[{"name":"Department of Internal Medicine , All India Institute of Medical Sciences Bhopal , India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohit","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , Cleveland Clinic Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2019,9,9]]},"reference":[{"key":"2026042913131229190_j_rjim-2019-0011_ref_001_w2aab3b7b9b1b6b1ab1ab1Aa","doi-asserted-by":"crossref","unstructured":"1. NEAME RL, CARR AJ, MUIR K, DOHERTY M. UK community prevalence of knee chondrocalcinosis: evidence that correlation with osteoarthritis is through a shared association with osteophyte. Ann Rheum Dis. 2003;62(6):513-8.10.1136\/ard.62.6.513175457912759286","DOI":"10.1136\/ard.62.6.513"},{"key":"2026042913131229190_j_rjim-2019-0011_ref_002_w2aab3b7b9b1b6b1ab1ab2Aa","doi-asserted-by":"crossref","unstructured":"2. FELSON DT, NAIMARK A, ANDERSON J, KAZIS L, CASTELLI W, MEENAN RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987;30(8):914-8.10.1002\/art.17803008113632732","DOI":"10.1002\/art.1780300811"},{"key":"2026042913131229190_j_rjim-2019-0011_ref_003_w2aab3b7b9b1b6b1ab1ab3Aa","doi-asserted-by":"crossref","unstructured":"3. BOUVET JP, LE PARC JM, MICHALSKI B, BENLAHRACHE C, AUQUIER L. Acute neck pain due to calcifications surrounding the odontoid process: the crowned dens syndrome. Arthritis Rheum. 1985;28(12):1417-20.10.1002\/art.17802812154084331","DOI":"10.1002\/art.1780281215"},{"key":"2026042913131229190_j_rjim-2019-0011_ref_004_w2aab3b7b9b1b6b1ab1ab4Aa","doi-asserted-by":"crossref","unstructured":"4. ZHANG W, DOHERTY M, BARDIN T, BARSKOVA V, GUERNE P-A, JANSEN TL, et al. European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis. Ann Rheum Dis. 2011;70(4):563-70.10.1136\/ard.2010.13910521216817","DOI":"10.1136\/ard.2010.139105"},{"key":"2026042913131229190_j_rjim-2019-0011_ref_005_w2aab3b7b9b1b6b1ab1ab5Aa","doi-asserted-by":"crossref","unstructured":"5. LEE GS, KIM RS, PARK HK, CHANG JC. Crowned dens syndrome: a case report and review of the literature. Korean J Spine 11: 15-17, 2014.10.14245\/kjs.2014.11.1.15","DOI":"10.14245\/kjs.2014.11.1.15"},{"key":"2026042913131229190_j_rjim-2019-0011_ref_006_w2aab3b7b9b1b6b1ab1ab6Aa","doi-asserted-by":"crossref","unstructured":"6. KODA R, TSUCHIDA Y, YOSHIZAWA K, SUZUKI K, KASAI A, TAKEDA T, et al. Crowned dens syndrome as an initial manifestation of crystalline deposition disease. Intern Med. 2015;54(18):2405-8.10.2169\/internalmedicine.54.457126370870","DOI":"10.2169\/internalmedicine.54.4571"},{"key":"2026042913131229190_j_rjim-2019-0011_ref_007_w2aab3b7b9b1b6b1ab1ab7Aa","doi-asserted-by":"crossref","unstructured":"7. MATSUMURA M, HARA S. Images in clinical medicine. Crowned dens syndrome. N Engl J Med. 2012;367(23):e34.10.1056\/NEJMicm110076423215579","DOI":"10.1056\/NEJMicm1100764"},{"key":"2026042913131229190_j_rjim-2019-0011_ref_008_w2aab3b7b9b1b6b1ab1ab8Aa","doi-asserted-by":"crossref","unstructured":"8. AOUBA A, VUILLEMIN-BODAGHI V, MUTSCHLER C, DE BANDT M. Crowned dens syndrome misdiagnosed as polymyalgia rheumatica, giant cell arteritis, meningitis or spondylitis: an analysis of eight cases. Rheumatology (Oxford) 2004;43: 1508-12.10.1093\/rheumatology\/keh37015316123","DOI":"10.1093\/rheumatology\/keh370"},{"key":"2026042913131229190_j_rjim-2019-0011_ref_009_w2aab3b7b9b1b6b1ab1ab9Aa","doi-asserted-by":"crossref","unstructured":"9. NAGASAKI H, DOI H. Crowned dens syndrome mimicking meningitis: Report of two cases. Neurology and Clinical Neuroscience. 2017;5(1):39\u201341.10.1111\/ncn3.12101","DOI":"10.1111\/ncn3.12101"},{"key":"2026042913131229190_j_rjim-2019-0011_ref_010_w2aab3b7b9b1b6b1ab1ac10Aa","doi-asserted-by":"crossref","unstructured":"10. SATO Y, YASUDA T, KONNO S, KUWAYAMA A, KOMATSU K. Pseudogout showing meningoencephalitic symptoms: crowned dens syndrome. 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