see: [RCH - acquired torticollis](https://www.rch.org.au/clinicalguide/guideline_index/Acquired_Torticollis/), [[paediatric c-spine]] > [!key points] > - if torticollis occurs in setting of trauma, manage as C-spine assessment > - if child has signs of fever, infection, or abnormal neurology, appropriate imaging should be performed to establish a cause > - most children will have a muscular torticollis and can be managed with simple analgesia **causes:** - muscle spasm (wry neck) - trauma: fracture, dislocation, spinal haematoma - atlantoaxial rotary subluxation / fixation - infection : head and neck (eg [[Parapharyngeal abscess|retropharyngeal abscess]]), spine, CNS, upper lobe chest - inflammation: juvenile idiopathic arthritis - neoplasm: CNS (posterior fossa) and bone tumours - dystonic syndromes (idiopathic spasmodic torticollis, drug rxn) - ocular dysfunction - benign paroxysmal torticollis **Red flags:** - fever - drooling - neurological symptoms (headache, strabismus, diplopia, photophobia, ataxia) **Treatment:** - heat pack, massage, basic analgesia -