Atlantoaxial Rotatory Subluxation in a 10-Year-Old Boy.

Area of Science:

• Pediatric Orthopedics
• Chiropractic Medicine
• Endocrinology

Background:

• Atlantoaxial rotatory subluxation (AARS) involves instability between the atlas and axis vertebrae.
• Repetitive torticollis in children can indicate underlying AARS.
• Diagnosis relies on characteristic imaging findings like CT scans.

Observation:

• A 10-year-old boy with recurrent torticollis presented with AARS.
• Initial management included halter traction and neck bracing, with a complication from overcorrection.
• Despite persistent radiographic instability, chiropractic treatment was initiated after multidisciplinary spine team consultation.

Findings:

• Chiropractic care for 5 months rendered the child asymptomatic with improved neck mobility.
• The patient discontinued long-term acetaminophen use.
• Incidental bilateral gynecomastia was noted during follow-up surveillance.

Implications:

• Chiropractic treatment may offer a non-surgical option for managing pediatric AARS.
• The case suggests a potential link between acetaminophen use and sex hormone regulation in preteen boys.
• Further research is warranted to explore acetaminophen's endocrine-disrupting potential.