Une cause rare de cervicalgie febrile

Febrile cervical pain is often secondary to meningitis or spondylodiscitis and, exceptionally, to microcrystalline arthropathy. We here report a case. A 81-year old man with no particular personal history was hospitalized with febrile cervical pain. Initial diagnoses were meningitis and spondylodiscitis. Clinical examination showed overall stiffness of cervical rachis. Spinal MRI showed abnormality of the atlanto-axial articulation signal, enhanced after gadolinium injection with synovial hypertrophy associated with irregular and heterogeneous aspect of the dens of the axis. Serial atlanto-axial Computed Tomography (CT) scan showed peri-odontoid calcifications, confirming the diagnosis of crowned dens syndrome (CDS). Patient evolution was favorable under nonsteroidal anti-inflammatory drugs (NSAIDs). CDS deserves to be better known; it can mimic many disorders and be responsible for long term fever.