Atlantoaxial rotatory fixation.

PURPOSE OF REVIEW: This review provides the most up to date information on diagnosing and treating atlantoaxial rotatory fixation (AARF). The condition can be confused with torticollis, but primary care physicians should have a high index of suspicion for AARF as timely noninvasive treatment facilitates excellent outcomes.

RECENT FINDINGS: A variety of etiologies have been described to cause AARF, but is most commonly seen following a viral infection of the upper respiratory system. When diagnosed early, nonoperative measures including rest, cervical collars, and antiinflammatories/muscle relaxants can allow for full resolution, avoidance of surgery and excellent outcomes.

SUMMARY: Atlantoaxial rotatory fixation is a treatable condition without need for surgery in most cases. Dynamic computed tomography scan is the imaging modality of choice to diagnose and confirm resolution of the condition, as diagnosis requires documented pathologic subluxation between the first and second cervical vertebrae.