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