Twisted neck: insights into etiology and clinical outcomes of pediatric torticollis
Öz
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.
Anahtar Kelimeler
torticollis, pediatric, congenital torticollis, acquired torticollis
Etik Beyan
Çalışma protokolü Ankara Üniversitesi Etik Kurulu tarafından onaylandı (Onay No: İ06-536-25, 17 Temmuz 2025) ve Helsinki Deklarasyonu ilkelerine uygun olarak yürütüldü.
Kaynakça
- Herman MJ. Torticollis in infants and children: common and unusual causes. Instr Course Lect. 2006;55:647-53.
- Tomczak KK, Rosman NP. Torticollis. J Child Neurol. 2013;28:365-78.
- Gross PW, Chipman DE, Doyle SM. The tilts, twists, and turns of torticollis. Curr Opin Pediatr. 2023;35:118-123.
- Dayasiri K, Rao S. Fifteen-minute consultation: Evaluation of paediatric torticollis. Arch Dis Child Educ Pract Ed. 2023;108:17-21.
- Gundrathi J, Cunha B, Tiwari V, Mendez MD. Congenital torticollis. StatPearls. 2025. https://www.ncbi.nlm.nih.gov/books/NBK549778/ (accessed Nov 2025).
- Haque S, Bilal Shafi BB, Kaleem M. Imaging of torticollis in children. Radiographics. 2012;32:557-71.
- Gabobe Nor MF, Salah RM, Ahmed MAM, Hassan SA, Farah Yusuf Mohamud M. Acute torticollis reaction following metoclopramide use in a pediatric patient: A comprehensive case report and appraisal of current knowledge. Int Med Case Rep J. 2024;17:1037-40.
- Raucci U, Roversi M, Ferretti A, Faccia V, Garone G, Panetta F et al. Pediatric torticollis: Clinical report and predictors of urgency of 1409 cases. Ital J Pediatr. 2024;50:86.
- Macias CG. Acquired torticollis in children. UpToDate. https://www.uptodate.com/contents/acquired-torticollis-in-children (accessed Aug 2025).
- Sahin E, Aydemir S, Celtik T. Torticollis research in focus: Emerging trends, thematic shifts, and global collaboration patterns. Medicine (Baltimore). 2025;104:e43174.
