Keywords:
Musculoskeletal spine, Paediatric, Conventional radiography, CT, MR, Normal variants, Congenital, Trauma, Infection
Authors:
R. Turney, N. Jenkins, K. A. Kingston; York/UK
DOI:
10.1594/essr2017/P-0226
Background
Torticollis may be congenital or aquired and is encountered in both paediatric and adult populations.
It is characterised by shortening of the sternocleidomastoid muscle and a rotational deformity of the cervical spine which produces a secondary head tilt. Acquired torticollis is often asscociated with infection or trauma and is more common in older children and adults. In infants and younger children torticollis is more likely to be muscular (e.g.
fibromatosis colli) or congenital associated with anatomical anomalies of the craniocervical junction and / or upper cervical spine.
Radiologists play an important role in the diagnosis of cervical spine and neck abnormalities. These pathologies are rare,
particularly in a District General Hospital (DGH) setting. When such cases are encountered they can pose significant diagnostic challenge and be a cause of uncertainty unless the radiologist has particular expertise in this area.
This poster has been produced in response to such challenging encounters in patients with both acute and chronic presentation of torticollis and head tilt.
Possible aetiologies include:
CONGENITAL |
ACQUIRED |
Muscular (e.g.
hypoplastic SCM) |
Trauma |
Bony anomaly (e.g.
fusion anomaly) |
Atlantoaxial rotatory fixation |
Central Nervous System (e.g.
Chiari) |
Infection (e.g.
parapharyngeal abscess) |
Syndromes (e.g.
Down syndrome) |
Inflammatory (e.g.
JIA) |
|
Neoplastic (e.g.
brain or bone metastases) |