Case:  5 yo F with sudden onset of R sided neck pain, no PMHx

Presentation:  VS NL, no report of trauma, well appearing child crying, head twisted with chin pointing toward L shoulder

Diagnosis:  Torticollis.  Spasm of the sternocleidmastoid common in children.  On the differential is retropharyngeal abscess in patients with sore throat and fever and alantoaxial dissociation in patients with neck trauma or a history of Down Syndrome or connective tissue disorder.

Management: XR’s if concerned for alantoaxial dissociation.  Otherwise Diazepam 0.1mg/kg PO x 1 and Ibuprofen 10mg/kg PO x 1.  Discharge home with ibuprofen.

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