We report a case of pseudogout manifested by severe posterior neck pain. 
Pseudogout of the neck, also known as the crowned dens syndrome, causes acute 
neck pain characterized by calcium pyrophosphate dehydrate deposition around the 
odontoid process. Crowned dens syndrome is typified clinically by severe 
cervical pain and stiffness, often in conjunction with raised inflammatory 
markers. A 71-year-old man presented with severe neck pain. On admission, 
elevation of serum CRP level was confirmed. Magnetic resonance images showed no 
responsible abnormalities except for degenerating change of the spine. The 
patient was diagnosed as having pseudogout caused by calcium pyrophosphate 
dehydrate deposition based on cervical computed tomographic imaging, which 
showed linear calcification in the transverse ligament of the axis. After 
administration of non-steroidal anti-inflammatory drugs, the fever and neck pain 
disappeared and the CRP level returned to within the normal range. Pseudogout of 
the cervical spine should be considered as a differential diagnosis when we 
examine patients with acute neck pain. Cervical spinal computed tomographic scan 
is a more sensitive and useful examination method to diagnose this disease 
rather than magnetic resonance images.