- Congenital
— Cervical spine segmentation anomaly
— Fibromatosis colli - Acquired
— Atlanto axial rotatory subluxation from trauma
— Cervical lymphadenopathy and / or Retropharyngeal abscess
— Juvenile idiopathic arthritis
— Posterior fossa tumor or spinal cord tumor
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