Torticollis: The Daily PANCE Blueprint

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Torticollis: The Daily PANCE Blueprint

A 6-year-old boy is brought to the pediatrician's office by his mother, who reports that her son woke up this morning with his head tilted to the right and his chin turned to the left. The child denies any pain but appears uncomfortable. There is no history of trauma, fever, or recent infections. On physical examination, the sternocleidomastoid muscle appears shortened on the right side. Neurological examination is unremarkable. What is the most appropriate next step in the management of this patient?

A. Immediate cervical spine immobilization
B. Administer intravenous antibiotics for suspected retropharyngeal abscess
C. Initiate nonsteroidal anti-inflammatory drugs (NSAIDs) and a cervical collar
D. Urgent MRI of the cervical spine
E. Immediate surgical consultation for possible spinal epidural hematoma

Answer and topic summary

The answer is C. Initiate nonsteroidal anti-inflammatory drugs (NSAIDs) and a cervical collar

The child presents with acquired torticollis, characterized by head tilt toward the shortened sternocleidomastoid (SCM) and chin rotation to the opposite side. Given the absence of trauma, fever, or neurological deficits, the most likely cause is minor muscle injury or inflammation. Treatment in such cases typically involves NSAIDs for inflammation and a cervical collar for comfort.

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Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Spinal Disorders ⇒ Torticollis

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