Periodontoid calcifications: CT

Periodontoid calcifications are deposits around the odontoid process. Their radiological presence does not always imply symptoms.

Identify the axis, atlas and transverse ligament; examine multiple planes and distinguish ligamentous deposits from normal cortical bone.

The plate combines an axial section and sagittal reconstruction; hyperdense deposits surround the odontoid region.

Axial crystal deposition disease is possible. Crowned dens syndrome combines these findings with a compatible inflammatory neck-pain presentation.

Consider fracture, infection and other causes of acute neck pain as appropriate. Incidental calcifications do not explain every pain syndrome.

Assess acute upper-neck pain, limited rotation, fever and inflammatory markers; ask about previous peripheral arthritis.

Neurological deficit, trauma, meningeal signs or sepsis requires urgent assessment; avoid prematurely attributing symptoms to crystal deposition.

CT does not prove crystal composition. ACR/EULAR criteria are classification criteria used within a defined clinical framework.

Describe the calcifications, then integrate symptoms, laboratory findings and alternatives; do not equate every deposit with a clinical syndrome.

• 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