Acute neck pain caused by calcium pyrophosphate dehydrate deposition in the transverse ligament of the atlas: a case report.
Summary of "Acute neck pain caused by calcium pyrophosphate dehydrate deposition in the transverse ligament of the atlas: a case report."
We report a case of pseudogout manifested by severe posterior neck pain. Pseudogout of the neck, also known as the crowned dens syndrome, causes acute neck pain characterized by calcium pyrophosphate dehydrate deposition around the odontoid process. Crowned dens syndrome is typified clinically by severe cervical pain and stiffness, often in conjunction with raised inflammatory markers. A 71-year-old man presented with severe neck pain. On admission, elevation of serum CRP level was confirmed. Magnetic resonance images showed no responsible abnormalities except for degenerating change of the spine. The patient was diagnosed as having pseudogout caused by calcium pyrophosphate dehydrate deposition based on cervical computed tomographic imaging, which showed linear calcification in the transverse ligament of the axis. After administration of non-steroidal anti-inflammatory drugs, the fever and neck pain disappeared and the CRP level returned to within the normal range. Pseudogout of the cervical spine should be considered as a differential diagnosis when we examine patients with acute neck pain. Cervical spinal computed tomographic scan is a more sensitive and useful examination method to diagnose this disease rather than magnetic resonance images.
Affiliation
Department of Neurosurgery, Shinshu University School of Medicine.
Journal Details
This article was published in the following journal.
Name: No shinkei geka. Neurological surgery
ISSN: 0301-2603
Pages: 769-72
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21799227
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Neck Pain
Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck.
Calcium Pyrophosphate
An inorganic pyrophosphate which affects calcium metabolism in mammals. Abnormalities in its metabolism occur in some human diseases, notably HYPOPHOSPHATASIA and pseudogout (CHONDROCALCINOSIS).
Abdomen, Acute
A clinical syndrome with acute abdominal pain that is severe, localized, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases.
Chondrocalcinosis
Presence of calcium salts, especially calcium pyrophosphate, in the cartilaginous structures of one or more joints. When accompanied by attacks of goutlike symptoms, it is called pseudogout. (Dorland, 27th ed)
Pain, Referred
A type of pain that is perceived in an area away from the site where the pain arises, such as facial pain caused by lesion of the VAGUS NERVE, or throat problem generating referred pain in the ear.
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