Pediatric emergency medicine trisk 3616 3616

FIGURE 112.31 Magnetic resonance imaging (MRI) of a SCIWORA patient Accompanying cervical spine radiographs were normal The MRI demonstrates an area of cord contusion in the midcervical area (arrows ) This patient had physical evidence of a central cord syndrome (Reprinted with permission from Swischuk L Emergency Radiology of the Acutely Ill or Injured Child 2nd ed Baltimore, MD: Williams & Wilkins; 1986:710.) Torticollis (Wry Neck) Torticollis is a common complaint in the pediatric ED The clinician should always inquire about traumatic events because an underlying bone injury may be present Often, however, torticollis is caused by spasm of the sternocleidomastoid (SCM) muscle In the patient with muscular torticollis, their chin points toward the unaffected side, while SCM spasm occurs on the affected side This condition is different from rotary subluxation Rotary subluxation is a cervical spine injury that is often misdiagnosed or undiagnosed because of difficulty in interpreting a