Acute pseudogout of the neck, also known as the crowned dens syndrome, is a rare 
cause of neck pain characterised by crystalline deposition in periodontoid 
articular tissues. It is typified clinically by severe cervical pain and 
stiffness, often in conjunction with pyrexia and raised inflammatory markers. As 
such, it is often misdiagnosed. We report 2 cases of crowned dens syndrome 
masquerading respectively as meningitis and polymyalgia rheumatica, and review 
the literature with particular attention to the clinical and radiological 
aspects of this under-recognised condition.