I'm not sure it's that simple. Even in benign torticollis, the CT may
demonstrate some radiographic rotary malalignment. Is there a way to rule
this out or rule it in with certainty by doing a CT? I have been told
that the answer is no. Is there some study in the literature indicating
otherwise? -- Loren Yamamoto
On Thu, 14 Sep 2000, karin sadow wrote:
> Thank you to all who responded. After some reading and extensive discussion
> with the pediatric neurosurgeon at my hospital, I came up with some answers
> to my questions. For those of you interested, here is what I have found:
> If the chin points away from the SCM in spasm, it is usually torticollis,
> especially in the setting of no trauma. Can get a muscle relaxer in the ED
> and home with NSAIDS and a soft collar (for comfort) with follow-up for
> re-evaluation in 5 days if no improvement. Chin in this direction, however,
> does not exclude subluxation. If there is a history of trauma then imaging
> may be indicated. If mild trauma, can probably get plain films and DC if
> normal with therapy as above (some may still choose no imaging, though,
> depending on how minor the trauma). If significant trauma, may as well go
> right to CT.
> Chin pointing toward the SCM in spasm is rotary subluxation. You can
> probably go right to CT unless there is another reason to obtain a cspine
> Comments? Anyone interested in a prospective multicenter study? Please
> respond to me if so...
> Thanks for your time!
> Karin Sadow
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