Usefulness of cervical computed tomography and magnetic resonance imaging for rapid diagnosis of crowned dens syndrome: a case report and review of the literature

Highlights • We report a patient with crowned dens syndrome dramatically improved in five days following treatment with oral nonsteroidal anti-inflammatory medication. • This rare condition should be considered in the differential diagnosis of a possible etiology for fever, headache and cervical pain of unknown origin. • The rapid diagnosis of crowned dense syndrome, based mainly on a cervical CT scan and MRI can prevent invasive, expensive and useless investigations as well as a long course of potentially dangerous and inadequate treatments, notably with cortisone, or prolonged hospitalization in old patients. • It was very interesting that the soft tissue surrounding the odontoid process was hyperintense on magnetic resonance T2-weighted imaging with fat suppression. In addition, the signal change disappeared 2 weeks after the administration of oral non-steroidal anti-inflammatory drugs. • This is the first report of making reference to MRI findings of crowned dens syndrome.