Twisted neck: insights into etiology and clinical outcomes of pediatric torticollis
Abstract
Purpose: This study aimed to evaluate the demographic and clinical characteristics of pediatric torticollis, to compare congenital and acquired cases, and to identify predictors of hospitalization in a tertiary care setting.
Materials and Methods: We retrospectively analyzed 370 pediatric patients diagnosed with torticollis between 2014 and 2024 in both emergency and outpatient clinics of a tertiary pediatric hospital. Data included demographics, presenting complaints, physical examination findings, imaging studies, etiology, treatment, and hospitalization outcomes.
Results: The median age at presentation was 76.95 [IQR:33.37-128.46] months, with a slight male predominance. Acquired etiologies were the most common (93.2%), particularly trauma (78.0%) and infectious/inflammatory causes (17.7%), while congenital cases accounted for 6.8%. Infectious/inflammatory causes, especially retropharyngeal abscess and cervical lymphadenitis, represented the majority of admissions (68.3%). Among presenting complaints, fever and a history of trauma were significantly associated with hospitalization, while on physical examination, tenderness and restricted range of motion were significant predictors.
Conclusion: This study highlights that acquired causes, particularly trauma and infectious etiologies, predominate in pediatric torticollis. Although most cases are benign, hospitalization is often warranted when systemic or red-flag symptoms are present. Careful clinical evaluation supported by appropriate imaging remains essential for early recognition and optimal management.
Keywords
torticollis, pediatric, congenital torticollis, acquired torticollis
Ethical Statement
The study protocol was approved by the Ethics Committee of Ankara University (Approval No: İ06-536-25, 17 July 2025) and conducted in accordance with the principles of the Declaration of Helsinki.
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