Torticollis in childhood-a practical guide for initial assessment

Area of Science:

• Pediatric Medicine
• Neurology
• Orthopedics

Background:

• Torticollis is a frequent presenting symptom in pediatric patients, often mistaken for a diagnosis itself.
• Numerous and confusing etiologies exist for torticollis, complicating accurate diagnosis and timely treatment.
• Children with torticollis typically first present to primary or secondary care, increasing the risk of misdiagnosis or delayed specialist referral.

Purpose of the Study:

• To review common causes of pediatric torticollis.
• To introduce a novel clinical assessment tool (PINCH) for differential diagnosis.
• To propose an early management scheme for guiding treatment pathways.

Main Methods:

• Literature review of torticollis etiologies and current management.
• Development of the PINCH clinical assessment tool for primary care physicians.
• Outline of a practical management scheme for pediatric torticollis.

Main Results:

• Identified common causes of torticollis in the pediatric population.
• Introduced the PINCH acronym as a simple clinical assessment tool.
• Presented a management scheme to aid in diagnosis, imaging, and referral.

Conclusions:

• Torticollis can signify various underlying conditions requiring prompt recognition.
• The PINCH tool and management scheme can assist pediatricians in initial assessment and treatment.
• Effective management guides appropriate imaging and specialist referral for pediatric torticollis.