DDX of torticollis

• Cervical spine segmentation anomaly
• Fibromatosis colli
• Trauma
• Retropharyngeal abscess
• Juvenile idiopathic arthritis
• Posterior fossa tumor or spinal cord tumor

Approach to the DDX of torticollis:

• If congenital: investigate first with neck ultrasound looking for fibromatosis colli and if this is unremarkable investigate second with cervical spine radiographs looking for a cervical spine segmentation anomaly
• C1-C2 rotatory subluxation is a common finding in trauma patients, patients with head and neck infections such as retropharyngeal abscess, and patients with cervical inflammation such as juvenile idiopathic arthritis
• Finally, consider posterior fossa or spinal cord tumor as an etiology