Differential diagnosis of pediatric torticollis

Approach to the differential diagnosis 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