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A Man With Headache, Fever, and Neck Stiffness

Educational Objective
Based on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis.
1 Credit CME

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Article Information

Corresponding Author: Dimitrios Farmakiotis, MD, Rhode Island Hospital, 593 Eddy St, Gerry House 111, Providence, RI 02903 (Dimitrios.Farmakiotis@lifespan.org).

Published Online: March 29, 2019. doi:10.1001/jama.2019.1772

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for providing permission to share his information.

References
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Aouba  A, Vuillemin-Bodaghi  V, Mutschler  C, De Bandt  M.  Crowned dens syndrome misdiagnosed as polymyalgia rheumatica, giant cell arteritis, meningitis or spondylitis: an analysis of eight cases.  Rheumatology (Oxford). 2004;43(12):1508-1512. doi:10.1093/rheumatology/keh370PubMedGoogle ScholarCrossref
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Salaffi  F, Carotti  M, Guglielmi  G, Passarini  G, Grassi  W.  The crowned dens syndrome as a cause of neck pain.  Clin Exp Rheumatol. 2008;26(6):1040-1046.PubMedGoogle Scholar
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