Abstract
Tortikollis, özellikle aileleri endişelendirebilmesi nedeniyle, çocuklarda yaygın acile başvuru nedenlerinden birisidir. Bu durum travmatik veya non travmatik olmak üzere pek çok durumla ilişkili olabilir. Ani başlangıçlı tortikolisin nadir nedenlerinden biri de, boyunda rotasyon kısıtlılığı ve hareketle artan ağrı ile karakterize olan atlantoaksiyel rotasyonel subluksasyondur. Genellikle geçirilmiş bir travma öyküsü ile ilişkilidir. Geçici ve kendini sınırlayan bir durum olarak bilinse de, erken tanı konmadığı takdirde ciddi rotasyon deformitelerine neden olabilmektedir. Bu sebeple, nedeni saptamak ve uygun tedaviyi sunmak oldukça önemlidir. Tanı için fizik muayene ve anamnez büyük ölçüde yeterli olsa da, arada kalınmış vakalarda direkt grafi ve bilgisayarlı tomografi göz önünde bulundurulabilir. Tedavi seçenekleri semptomlara ve hastanın genel durumuna göre değişmekle birlikte, ilk aşama olarak boyunluk kullanımı ve anti inflamatuar ilaçlarla konservatif yaklaşım önerilir.
Çocuk yaş grubunda çoğunlukla atlanan bu tanı açısından farkındalığı arttırmak adına, kliniğimizde atlantoaksiyel rotatuar subluksasyon tanısı koyduğumuz 13 yaşındaki kız hastamızı sunmak istedik.
Supporting Institution
yok
References
- Referans 1- Pang D, Li V. Atlantoaxial rotatory fixation: Part 1--Biomechanics of normal rotation at the atlantoaxial joint in children. Neurosurgery. 2004;55(3):614-26
- Referans 2- Tubbs RS, Hallock JD, Radcliff V, et al. Ligaments of the craniocervical junction. J Neurosurg Spine. 2011;14(6):697-709
- Referans 3- Tang CH, Chiu YC, Tan TW, Yang RS, Fu WM. Adiponectin enhances IL-6 production in human synovial fibroblast via an AdipoR1 receptor, AMPK, p38, and NF-kappa B pathway. J Immunol. 2007;179(8):5483-92
- Referans 4- Neal KM, Mohamed AS. Atlantoaxial rotatory subluxation in children. J Am Acad Orthop Surg. 2015;23(6):382-92
- Referans 5- Sferopoulos NK. Atlantoaxial rotatory subluxation in children: A review. J Radiol Med Imaging. 2018;2:1009
- Referans 6- Pang D, Li V. Atlantoaxial rotatory fixation: part 2--new diagnostic paradigm and a new classification based on motion analysis using computed tomographic imaging. Neurosurgery. 2005;57(5):941-53
- Referans 7- Bredenkamp JK, Maceri DR. Inflammatory torticollis in children. Arch Otolaryngol Head Neck Surg. 1990;116(3):310-13
- Referans 8- Subach BR, McLaughlin MR, Albright AL, Pollack IF. Current management of pediatric atlantoaxial rotatory subluxation. Spine (Phila Pa 1976). 1998;23(20):2174-79
- Referans 9- Samartzis D, Shen FH, Herman J, Mardjetko SM. Atlantoaxial rotatory fixation in the setting of associated congenital malformations: a modified classification system. Spine (Phila Pa 1976). 2010;35(4):E119-27
- Referans 10- Schwarz N. The fate of missed atlanto-axial rotatory subluxation in children. Arch Orthop Trauma Surg. 1998;117(4-5):288-89
Abstract
Torticollis is one of the common causes of admission to the emergency department among children which can make parents worried. This could be related to many traumatic and non-traumatic conditions. One of the rare causes of acute onset of torticollis is atlantoaxial rotatory subluxation, which is characterized by limitation of neck rotation, increased pain by movement. It is generally associated with a past trauma history. Although it is known as a temporary and self-resolving condition, if it is not diagnosed earlier it may lead to severe rotational deformity of the cervical spine. Therefore, detecting certain causes and providing proper treatment are highly important. Physical examination and history are usually enough to make the diagnosis, yet cervical X-ray and computed tomography scan can be considered for indefinite cases. Even though treatment options depend on symptoms and the patient's general status, conservative approach with cervical collar and anti-inflammatory drugs are recommended as a first step.
We would like to present our case, a 13 year-old girl who has been diagnosed with atlantoaxial rotatory subluxation in our clinic to increase awareness of this condition which is often misdiagnosed in children.
References
- Referans 1- Pang D, Li V. Atlantoaxial rotatory fixation: Part 1--Biomechanics of normal rotation at the atlantoaxial joint in children. Neurosurgery. 2004;55(3):614-26
- Referans 2- Tubbs RS, Hallock JD, Radcliff V, et al. Ligaments of the craniocervical junction. J Neurosurg Spine. 2011;14(6):697-709
- Referans 3- Tang CH, Chiu YC, Tan TW, Yang RS, Fu WM. Adiponectin enhances IL-6 production in human synovial fibroblast via an AdipoR1 receptor, AMPK, p38, and NF-kappa B pathway. J Immunol. 2007;179(8):5483-92
- Referans 4- Neal KM, Mohamed AS. Atlantoaxial rotatory subluxation in children. J Am Acad Orthop Surg. 2015;23(6):382-92
- Referans 5- Sferopoulos NK. Atlantoaxial rotatory subluxation in children: A review. J Radiol Med Imaging. 2018;2:1009
- Referans 6- Pang D, Li V. Atlantoaxial rotatory fixation: part 2--new diagnostic paradigm and a new classification based on motion analysis using computed tomographic imaging. Neurosurgery. 2005;57(5):941-53
- Referans 7- Bredenkamp JK, Maceri DR. Inflammatory torticollis in children. Arch Otolaryngol Head Neck Surg. 1990;116(3):310-13
- Referans 8- Subach BR, McLaughlin MR, Albright AL, Pollack IF. Current management of pediatric atlantoaxial rotatory subluxation. Spine (Phila Pa 1976). 1998;23(20):2174-79
- Referans 9- Samartzis D, Shen FH, Herman J, Mardjetko SM. Atlantoaxial rotatory fixation in the setting of associated congenital malformations: a modified classification system. Spine (Phila Pa 1976). 2010;35(4):E119-27
- Referans 10- Schwarz N. The fate of missed atlanto-axial rotatory subluxation in children. Arch Orthop Trauma Surg. 1998;117(4-5):288-89
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Report |
| Authors | |
| Publication Date | July 31, 2021 |
| Acceptance Date | April 7, 2021 |
| Published in Issue | Year 2021 |