Crowned tooth syndrome

case report

Abstract

The aim of this paper is to report a rare case of a patient with anterior neck pain, with significant neck pain, who was diagnosed with chondrocalcinosis around the odontoid, characterizing the Crowned Tooth Syndrome (CTS). CTShas a good prognosis. Unresponsive patients may benefit from moderate doses of steroids. The manifestations overlap with those of primary osteoarthritis, since both are common in old age. In addition, some radiographic clues that differentiate from primary osteoarthritis: hook-like osteophytes; axial skeleton involvement; narrowing of the radiocarpal or knee joint space, with meniscal calcification; and severe joint destruction. The main differential diagnosis is rheumatoid arthritis but can be misdiagnosed with cervical abscess. Patient 75 years old, doctor, chronic alcoholism, there was a great ingestion of wine and high protein diet for three days, he started to present severe pain (VAS 10) in the cervical spine not related to trauma or poor posture or physical exertion, mainly in the anterior region of the neck, radiating to the posterior and occipital region, in addition to an antalgic position rotating 30 degrees to right. In the CTSwe can find crystals deposits in the odontoid process region in the C2 vertebra (áxis). Thus, calcium pyrophosphate arthropathy is clinically associated with acute episodes of mono or oligoarthritis, called pseudogout, involving large joints, most commonly in knees, shoulder, hips and spine. There is intense inflammatory response to calcium pyrophosphate crystals causing heat, erythema and edema around the affected joint. The disease may also manifest itself in chronic form characterized by mild arthralgia or joint stiffness.