[Crowned Dens syndrome: calcification of the transverse ligament of the atlas].

Axial skeleton affection due to chondrocalcinosis has been associated to calcium deposits in the intervertebral disc, the yellow ligament, the fact joints and even the sacroiliac joints. Calcification of the transverse ligament of the atlas (Figs. 1–3) is an infrequent manifestation and has been denominated the Crown Dens syndrome. It mostly constitutes an asymptomatic clinical picture but may be associated with episodes of acute cervical pain, stiffness and fever, with the added diagnostic difficulties of these cases. We present the case of an 82-year-old woman who consulted us due to intense cervical pain which responded poorly to analgesics. She had a history of atrial fibrillation undergoing anticoagulation therapy, spondyloarthritis and radiologic chondrocalcinosis of the knees. Physical examination revealed spontaneous pain on the cervical spine, radiating to the occipital and mastoid regions, with stiffness and movement limitations due to pain, with no neurologic manifestations.