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2023

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LOOKING AT IT AT AN ANGLE: IMAGING OF TORTICOLLIS IN CHILDREN THROUGH THE EYES OF A NEURORADIOLOGIST

Mariana Diogo, Carla Conceição, Jaime Pamplona

Neuroradiology Department, Centro Hospitalar de Lisboa Central, Lisboa, Portugal

European Congress of Radiology (ECR), 4-8 March 2015, Vienna, Austria
Published online. DOI: 10.1594/ecr2015/C-0835     

Learning objectives:                        
Torticollis in children is mostly of soft tissue origin with no need for imaging, but it is more often related to central nervous system (CNS) or spine anomalies then in the adult population.                                     
The aim of this exhibit is to showcase a series of Computer Tomography (CT) and Magnetic Resonance (MR) imaging cases in pediatric patients with torticollis of CNS/Spinal origin.
Background:                                    
Torticollis is a deformity characterized by rotation of the cervical spine with secondary tilting of the head. Although most are of muscular origin, it may be a sign of an underlying disease process: some benign, others requiring immediate intervention like CNS tumors or infections.                                     
The use of imaging is common in the work-up of torticollis in a child, and radiologists must understand and the array of possible findings in this specific population.
Findings and procedure details:                            
We present a series of illustrative CT and MR imaging cases collected from our institution’s neuroradiology imaging archive.                                              
Examples of main pathological groups will be presented and imaging characteristics and pitfalls described. These include: traumatic, posterior fossa and cervical tumors, bony malformations of the skull base and cervical spine, inflammatory and infectious pathologies and some rare and syndromic diseases.                                                        
Conclusion:                          
Torticollis is usually a self limited deformity of muscular origin, with no need for imaging characterization. CT is the prefered imaging technique when suspecting a bony cause and MR when CNS sources are suspected. Radiologists should be aware of the different causes of torticollis in children in order to aid in the diagnosis help direct the treatment.