Crystal deposition in the cervical spine around the odontoid process may lead to 
acute neck pain. This rare condition is called crowned dens syndrome and should 
be considered in the differential diagnosis of a possible etiology for fever, 
headache and cervical pain of unknown origin. The syndrome is often overlooked, 
thus leading to misdiagnosis, invasive and useless investigations (lumbar 
puncture, biopsy), inappropriate treatment (steroids, antibiotics, antiviral 
drugs) and prolonged hospitalization. This can be prevented by imaging, based on 
a cervical CT scan that allows an accurate diagnosis. The disease has a good 
prognosis and symptoms usually subside within a few weeks. We describe a patient 
with crowned dens syndrome which manifested with clinical (acute occipital 
headache) and radiographic (calcium deposits in the alar ligament) features. Our 
patient recovered in four days with symptomatic therapy.