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I read with interest the short report by Dr Natarajan.
We need to be aware of such sinister pathologies even when dealing
with adult patients presenting with neck pain and deformity e.g.
torticollis. Many a times, the x-ray picture is normal. It is the
persistence and worsening of symptoms which prompts the clinician to
I was involved in the management of a middle age man...
I was involved in the management of a middle age man who presented with
persistent neck pain, torticollis and earache. He had to support his head
with his hands to relieve the pain. Initial x-rays were normal and it was
further investigations with CT and MRI that revealed an abscess involving
C2 to C4 vertebrae. In retrospect the large soft tissue swelling seen on
the initial x-rays was identified. The patient underwent debridement and
stabilization and made full recovery.
Neck pain with torticollis of acute onset is always a condition which
needs thorough investigation and management.