Acute Hematogenous Osteomyelitis of the Odontoid Process in a Child With Torticollis

Abstract

Acute vertebral osteomyelitis is rare in the pediatric population. Its presentation may be subtle and without constitutional manifestations. We present a case of osteomyelitis of the odontoid process. The disease was not considered in the initial evaluation of an afebrile, nontoxic child who presented for evaluation of neck stiffness. Although there was a delay in diagnosis and treatment, the outcome was favorable.

Torticollis in Children

“…Third, osteomyelitis of the odontoid was found in one case with the longest history of symptoms before MRI suggesting that an infection was a late complication of septic C1-C2 arthritis as previously reported. 1-3…”

“…1,2 The aim of this study is to report this cause of cervical arthritis in children. A search on PubMed using the keywords "atlanto-axial septic arthritis" or "C1-C2 septic arthritis" associated to "torticollis" could not find any pediatric case.…”

“…We found only cases of “osteomyelitis of the odontoid” with torticollis. 1,2 The aim of this study is to report this cause of cervical arthritis in children. We first describe in detail 4 observations of torticollis in children secondary to C1-C2 septic arthritis then discuss this issue.…”

Conservative Care of Pediatric Acquired Torticollis: A Report of 2 Cases

“…[4][5][6][7][8][9][10][11][12][13][17][18][19][20][21] The only case series in the literature featuring chiropractic management concerns missed diagnoses of underlying pathologies. 22 One case report of a child with congenital torticollis details how several providers missed diagnosing holocord astrocytoma resulting in quadriplegia.…”

Neonatal C1 to C2 Osteomyelitis Leading to Instability and Neurological Decline

“…[1][2][3][4][5] In infants, the combination of a large head, developing neck muscles, and relatively lax ligaments contribute to a potential instability of the craniocervical junction. [1][2][3][4][5] In infants, the combination of a large head, developing neck muscles, and relatively lax ligaments contribute to a potential instability of the craniocervical junction.…”