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[Pediatric intervertebral disc calcification: A rare cause of acquired torticollis. Case report]
Yerko Cuevas1, Luisa Schonhaut2, Aníbal Espinoza3
1Servicio de Traumatología Infantil, Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago de Chile, Chile.
Insights
Pediatric intervertebral disc calcification is a rare condition causing neck pain and torticollis in children. This condition typically has a benign, self-resolving outcome with conservative treatment.
Area of Science:
- Pediatric Radiology
- Pediatric Orthopedics
- Rheumatology
Background:
- Neck pain and cervical muscle spasm are frequent pediatric emergency department complaints.
- Musculoskeletal damage evaluation includes medical history, physical examination, and cervical spine X-rays.
- Intervertebral disc calcification is a rare finding that should be considered in pediatric neck pain cases.
Observation:
- A 7-year-old male presented with a 6-day history of neck pain and contracture.
- Slightly elevated C-reactive protein and erythrocyte sedimentation rates were noted.
- Imaging revealed calcification of the C5-C6 intervertebral disc with anterior disc protrusion.
Findings:
- The patient received conservative management including hospitalization for pain control, non-steroidal anti-inflammatory drugs, and a soft collar.
- Clinical symptoms and imaging-confirmed calcifications resolved within 6 months.
- Pediatric intervertebral disc calcification presented as a rare cause of acquired torticollis.
Implications:
- Intervertebral disc calcification in children is a rare but important diagnosis in the differential for torticollis.
- The condition generally follows a benign and self-limited clinical course.
- Conservative management and follow-up are recommended for pediatric intervertebral disc calcification.
Introduction:
Pain and cervical muscle spasm are common reasons why parents bring children to the pediatric emergency department. The first steps are the gathering of medical history of the patient and a physical examination. If musculoskeletal damage is suspected, cervical spine x-rays should be obtained. An intervertebral disc calcification finding, in the absence of other radiological lesions should suggest pediatric intervertebral disc calcification.
Objective:
To present a case of intervertebral disc calcification, a rare condition that must be considered in the differential diagnosis of torticollis and neck pain in childhood.
Case Report:
A seven-year-old male patient without morbid history and no history of trauma or rough sport practice. He consulted the emergency room for pain and cervical contracture for the last six days. C reactive protein and red cell sedimentatio rates were slightly elevated. Imaging studies showed calcification of the C5-C6 intrvertebral disc and anterior disc protrusion. The patient was hospitalized for evaluation and pain management, with good clinical response and continue afterwards with non-steroidal anti-inflammatory drugs and a soft collar. At the 6-month-follow up, the patient had resolved symptoms and calcifications.
Conclusions:
Pediatric intervertebral disc calcification is a rare cause of acquired torticollis, with a benign and self-limited outcome. Conservative management, as well as clinical and imaging follow-up is recommended.
