Paediatrics & child health · 2026
Predictors of clinically significant underlying etiologies in children presenting with torticollis.
СтатьяНазвание и аннотация: Перевод в очереди
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Shemer Matan, Noyman Shai, Rimon Ayelet, Cohen Neta
Аннотация
BACKGROUND: Torticollis is a common presentation in paediatric emergency departments (PEDs), usually benign but sometimes the first sign of serious pathology.
METHODS: We retrospectively reviewed children <18 years presenting with torticollis to the PED at Tel Aviv Sourasky Medical Center (2018 through 2023). The primary outcome was a clinically significant underlying condition: (1) infectious aetiology, (2) head, neck, or cervical spine tumour or (3) atlantoaxial rotatory fixation (AARF) requiring intervention.
RESULTS: Among 352 children (median age 4.8 years; 52% male), 59 (17%) had a clinically significant diagnosis: infectious causes (35/59 [59%]), AARF (18/59 [30%]) and tumours (6/59 [10%]). Infectious cases were younger (P = 0.03), more likely to be febrile (P < 0.001), and had higher C-reactive protein levels (P < 0.001). AARF was associated with older age (P = 0.002), prolonged symptoms (P < 0.001), midline tenderness (P = 0.002) and restricted motion (P < 0.001).
CONCLUSION: One in six children with torticollis had a serious underlying condition, supporting a structured, symptom-guided diagnostic approach.
METHODS: We retrospectively reviewed children <18 years presenting with torticollis to the PED at Tel Aviv Sourasky Medical Center (2018 through 2023). The primary outcome was a clinically significant underlying condition: (1) infectious aetiology, (2) head, neck, or cervical spine tumour or (3) atlantoaxial rotatory fixation (AARF) requiring intervention.
RESULTS: Among 352 children (median age 4.8 years; 52% male), 59 (17%) had a clinically significant diagnosis: infectious causes (35/59 [59%]), AARF (18/59 [30%]) and tumours (6/59 [10%]). Infectious cases were younger (P = 0.03), more likely to be febrile (P < 0.001), and had higher C-reactive protein levels (P < 0.001). AARF was associated with older age (P = 0.002), prolonged symptoms (P < 0.001), midline tenderness (P = 0.002) and restricted motion (P < 0.001).
CONCLUSION: One in six children with torticollis had a serious underlying condition, supporting a structured, symptom-guided diagnostic approach.