A Diagnosis Fit for a Queen: Crowned Dens Syndrome.

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We describe a case of an elderly female patient with a history of pseudogout who presented to the emergency department with atraumatic neck pain, fever, and malaise, who was found to have crowned dens syndrome on computed tomography imaging. It is important that emergency physicians consider crowned dens syndrome in elderly patients presenting with neck pain and signs of inflammation to ensure timely diagnosis, treatment, and to minimize unnecessary invasive testing.