An 87-year-old woman with corticosteroid-resistant polymyalgia rheumatica 
underwent ¹⁸F-FDG PET/CT for suspected giant cell arteritis or neoplastic 
disease. FDG uptake in the immediate vicinity of the odontoid process, with a 
crownlike calcification, was identified on the CT scan on the posterior side of 
the dens, thus confirming the diagnosis of crowned dens syndrome. Because this 
rare syndrome is frequently misdiagnosed, nuclear physicians should be aware of 
the signs and symptoms of this condition, which may call for the use of PET/CT 
imagery.