齿状突加冠综合征的诊断学特征并文献复习

Diagnostic features of crowned dens syndrome and literature review

目的探讨齿状突加冠综合征的临床诊断学特征。方法回顾性分析2019年12月至2020年4月济宁医学院附属医院邹城院区脊柱外科收治的2例齿状突加冠综合征患者的临床和影像学资料,总结齿状突加冠综合征的诊断学特征,并文献复习。结果2例患者均因急性颈部疼痛伴颈部活动受限就诊,既往有糖尿病病史,均无发热,实验室检查C反应蛋白(CRP)水平均升高,其中1例患者红细胞沉降率(ESR)水平升高。颈椎CT检查均提示颈椎退行性变,齿状突上方骨性密度灶,排除脑膜炎、痛风,诊断为“齿状突加冠综合征”。结论CRP和(或)ESR水平升高,颈椎CT见齿状突周围钙化是诊断齿状突加冠综合征的重要实验室和影像特征。

Objective To explore the clinical diagnostic features of crowned dens syndrome(CDS).Methods From December 2019 to April 2020,the clinical and imaging data of two patients with CDS who were admitted to Spinal Surgery Department of Zoucheng Branch of Affiliated Hospital of Jining Medical University were retrospectively analyzed.The diagnostic features of CDS were summarized,and literatures were reviewed.Results Both patients presented to the hospital due to acute neck pain and restricted neck mobility,and had a history of diabetes and none of them had a fever.The C-reactive protein(CRP)levels of both 2 patients inereased,and the erythrocyte sedimentation rate(ESR)level of one patient increased.CT examination of the cervical spine both showed degeneration changes of cervical spine,and bone density lesions in above the odontoid process.The CDS diagnosis was established excluding meningitis and gout.Conclusion Elevated levels of CRP and(or)ESR,cervical calcification around the odontoid process on CT scan are important laboratory and imaging features for the diagnosis of CDS.