Original MICA image-reading exercise, unscored. No clinical narrative absent from the source is added.
- Describe visible findings before proposing an interpretation.
- Suggest an interpretation and at least one image limitation.
- Which clinical findings or investigations would complement this observation?
Reveal the explained reading
Periodontoid calcifications: CT
- Location
- C1–C2 junction
- Appearance
- Calcific deposits
- Modality
- Bone-window CT
- Syndrome
- Clinical and imaging findings
Morphological description
The plate combines an axial section and sagittal reconstruction; hyperdense deposits surround the odontoid region.
Causes and diagnostic direction
Axial crystal deposition disease is possible. Crowned dens syndrome combines these findings with a compatible inflammatory neck-pain presentation.
Differential diagnoses
Consider fracture, infection and other causes of acute neck pain as appropriate. Incidental calcifications do not explain every pain syndrome.
Pitfalls and limitations
CT does not prove crystal composition. ACR/EULAR criteria are classification criteria used within a defined clinical framework.
Take-home message
Describe the calcifications, then integrate symptoms, laboratory findings and alternatives; do not equate every deposit with a clinical syndrome.
Sources
- Abhishek et al. The 2023 ACR/EULAR Classification Criteria for Calcium Pyrophosphate Deposition Disease ↗
- Mandl et al. 2023 EULAR recommendations on imaging in diagnosis and management of crystal-induced arthropathies (2024) ↗
Documentary review: 2026-10-15
Media source & rights
- Author
- Hellerhoff
- Original source
- Hellerhoff — Crowned dens - 95jw - CT axial und sagittal - 001.jpg — CC BY-SA 3.0 — https://commons.wikimedia.org/wiki/File:Crowned_dens_-_95jw_-_CT_axial_und_sagittal_-_001.jpg
- Licence
- CC BY-SA 3.0
- Changes
- Full original field and annotations retained; WebP conversion, EXIF/GPS metadata removed, proportional derivatives without upscaling, cropping or medical retouching. Derivatives shared under the same CC BY-SA 3.0 licence.
- Dimensions
- 2052 × 1056 px
- Check
- 2026-10-15