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Study Summary: Clinical Characteristics of Pediatric Torticollis
Background
- The cause and risk factors of torticollis in children are not well understood, especially in the Emergency Department (ED) setting.
- It is crucial to distinguish between benign and potentially life-threatening conditions in children with torticollis.
Methods
- Retrospective study of 1409 pediatric patients with acute torticollis over 13 years in a tertiary pediatric hospital’s ED.
- Two subgroups were analyzed based on the urgency of the underlying condition.
- A multivariate model was developed to identify clinical predictors of the need for urgent care.
Results
- Median age of patients: 5.7 years.
- 27.9% had a history of trauma, and 83.5% experienced pain.
- 5.4-7.9% of patients had pathological findings on further imaging.
- 11.1% of cases required hospitalization (median duration: 4 days).
- Most common etiologies: postural (43.1%), traumatic (29.5%), infective/inflammatory (19.1%).
- Longer duration of torticollis and presence of headache or vomiting were strongly correlated with an urgent condition.
Conclusion
- Patients with a history of trauma or experiencing headache, vomiting, and torticollis for over 24 hours should undergo further evaluation and short-term follow-up.
- Invasive or expensive investigations should be limited to patients with clinical suspicion of a harmful condition.
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