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Red Flags in Torticollis

A Historical Cohort Study

Starc, Meta MD*; Norbedo, Stefania MD; Tubaro, Martina MD*; Ronfani, Luca MD; Bassanese, Giulia MD*; Barbi, Egidio MD*†

doi: 10.1097/PEC.0000000000001377
Original Articles

Objective This study aimed to assess the spectrum of pathologies responsible for torticollis in children presenting to the emergency department and to evaluate the associated symptoms to determine clinical red flags for hospitalization.

Methods This was a historical retrospective cohort study. Medical records of children evaluated in our emergency department for torticollis from 2008 to 2013 were reviewed.

Results Among 392 identified patients, 61% had postural torticollis,19.4% infection related, 16.3% traumatic, and 3.5% other. Twenty-five patients (6.4%) were hospitalized. Four variables were strongly and independently related to the severe outcome: fever, sore throat, headache, and age.

Conclusions The association of 2 or 3 of these 4 features carried a risk of 32% and 58%, respectively, of having a severe illness.

From the *University of Trieste; and

Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy.

Disclosure: The authors declare no conflict of interest.

Reprints: Stefania Norbedo, MD, Institute of Child Health, IRCCS Burlo Garofolo Trieste, Trieste, Italy (e-mail:

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