Crowned dens syndrome developed after an endoscopic retrograde cholangiopancreatography procedure

Figure 1 Abdominal computed tomography scan on admission. There are multiple small computed tomography-high density stones on lower common bile duct (white arrow).

Figure 2 Emergent endoscopic retrograde cholangiopancreatography. With endoscopic sphincterotome and mechanical lithotripsy, all stones could be removed successfully without any complications of either hemorrhage or gastrointestinal perforation.

Figure 3 Cervical computed tomography and radiograph of the right wrist and left knee on day 4 after endoscopic retrograde cholangiopancreatography. A: A sharply defined calcification of periodontoid articular ligaments is noted (white arrow); B: The same as (A) on sagittal view; C: Crystal deposit in the right wrist joint space (white arrow); D: Crystal deposit in left knee joint space (white arrow).