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Case Reports
. 2017 May 26:2017:bcr2016216768.
doi: 10.1136/bcr-2016-216768.

Kicked to touch: Hoodwinked by torticollis

Ciaran K Mc Donald  1 , Niall Mc Goldrick  2 , Cliodhna Ni Fhoghlu  3 , Fintan Shannon  1
Affiliations
Case Reports

Kicked to touch: Hoodwinked by torticollis

Ciaran K Mc Donald et al. BMJ Case Rep. .

Abstract

A 2-year-old girl presented to the emergency department with a 3-day history of a painful stiff neck after getting a kick to her head from her older brother. Her general practitioner had recently started her on oral antibiotics for otitis media. Plain film imaging of her cervical spine on admission revealed anterior subluxation of C2 on C3 suggestive of bifacetal dislocation. Subsequent CT imaging confirmed malalignment of the upper cervical spine. The patient was admitted and worked up with MRI of the cervical spine which unexpectedly revealed a large 4×2 cm retropharyngeal abscess extending from C1 to C4. No associated structural abnormality of the spine was detected. This case report highlights the life-threatening causes of torticollis (retropharyngeal abscess and cervical spine injury), and summarises the anatomy and normal variants that one should expect on interpretation of cervical spine imagery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Cervical spine radiograph demonstrating subluxation of C2 vertebral body on C3.
Figure 2
Figure 2
CT cervical spine demonstrating subluxation of C2 vertebral body on C3.
Figure 3
Figure 3
MRI neck demonstrating 4×2 cm retropharyngeal abscess.
Figure 4
Figure 4
Cervical spine radiograph demonstrating correct interspinous alignment.
See this image and copyright information in PMC

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