Differential diagnosis of acquired torticollis in children

Trauma

C1-C2 subluxation

C1-C2 dislocation

Clavicle fracture

Cervical spine fracture

Muscle injury

Ligamentous injury

Spinal epidural hematoma

Infection

Upper respiratory infection

Cervical adenitis

Pharyngitis

Retropharyngeal abscess

Upper lobe pneumonia

Cervical osteomyelitis

Cervical diskitis

Tuberculosis

Lemierre syndrome

Tumors

Posterior fossa

Intraspinal

Osteoid osteoma

Eosinophilic granuloma

Neurogenic

Myasthenia gravis

Poliomyelitis

Dystonia

Kernicterus

Huntington chorea

Wilson disease

Neuritis of spinal accessory nerve

Ocular

Superior oblique palsy

Congenital nystagmus

Refractive errors

Strabismus

Miscellaneous

Myositis or fibromyositis

Gastroesophageal reflux

Juvenile idiopathic arthritis

Spasmus nutans

Benign paroxysmal torticollis

Drug-induced

Ligamentous laxity

Functional torticollis

Polymyositis

Calcification of the intervertebral disks

Idiopathic intracranial hypertension (pseudotumor cerebri)

Adapted from: Torticollis. In: Signs and symptoms in pediatrics, 3rd ed, Tunnessen WW, Roberts KB (Eds), Lippincott, Williams and Wilkins, Philadelphia, 1999. p.353.

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Differential diagnosis of acquired torticollis in children