We report a case of CPPD crowned dens syndrome in an 87 year white old male with 
a known history of pseudogout, with clinical and radiological features 
characteristic of this syndrome. Interestingly, there was significant mass 
effect on the clivus, with clivus erosion and destruction, a finding that has 
not previously been described with this syndrome. The clinical and radiological 
characteristics of Crowned Dens syndrome, as well as CPPD are reviewed. We 
suggest that CPPD crowned dens syndrome may be included in the differential 
diagnosis when clivus destruction or erosion, in association with a soft tissue 
mass with calcification, is seen.