Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Crowned dens syndrome as a rare cause of anterior neck pain after transurethral resection of the prostate: a case report

  • Myeong Geun, Jeong (Keimyung University School of Medicine) ;
  • Bum Soon, Park (Keimyung University School of Medicine) ;
  • Eun-Seok, Son (Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine) ;
  • Jang Hyuk, Cho (Department of Rehabilitation Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine)
  • Received : 2022.05.27
  • Accepted : 2022.06.26
  • Published : 2023.07.31
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Abstract

We describe the case of a 79-year-old man who presented with progressive aggravation of severe axial neck pain and fever 3 days after transurethral resection of the prostate (TURP), despite maintaining neutral neck posture during surgery. Laboratory examination revealed markedly elevated C-reactive protein levels and erythrocyte sedimentation rates. Computed tomography revealed crown-like calcifications surrounding the odontoid process. We diagnosed crowned dens syndrome (CDS) as the cause of acute-onset neck pain after TURP. The patient was treated with nonsteroidal anti-inflammatory drugs for 5 days, and his symptoms resolved completely. CDS is a rare disease characterized by calcific deposits around the odontoid process with acute onset of severe neck pain and restricted motion. Evidence of inflammation on serological testing and fever are typical of CDS. However, the prevalence and pathophysiology of CDS remain unclear. We hypothesized that systemic inflammation after prostate surgery may have induced a local inflammatory response involving calcification around the odontoid process.

Keywords

Acknowledgement

This research was funded by the Korea Institute of Machinery & Materials with a grant from the Basic Research Program (grant No. NK238D-03).

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