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Approach to neck stiffness in children

Marisa Brett-Fleegler, MD
Section Editors
Stephen J Teach, MD, MPH
Jan E Drutz, MD
Gary R Fleisher, MD
Deputy Editor
James F Wiley, II, MD, MPH


This topic will review the approach to neck stiffness in children.

The evaluation of acquired and congenital torticollis in children is discussed separately:

(See "Acquired torticollis in children".)

(See "Congenital muscular torticollis: Clinical features and diagnosis" and "Congenital muscular torticollis: Management and prognosis".)


Neck stiffness is a common complaint in pediatrics, and it presents to both the emergency and primary care provider. The term refers to either an abnormal preferred position of the neck, or a normal position associated with restricted range of motion. A broad range of conditions from benign to life-threatening may present with neck stiffness as a primary complaint or accompanying other concerns.


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Literature review current through: Sep 2016. | This topic last updated: Nov 18, 2015.
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  1. Pharisa C, Lutz N, Roback MG, Gehri M. Neck complaints in the pediatric emergency department: a consecutive case series of 170 children. Pediatr Emerg Care 2009; 25:823.
  2. Pang D. Spinal cord injury without radiographic abnormality in children, 2 decades later. Neurosurgery 2004; 55:1325.
  3. Craig FW, Schunk JE. Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management. Pediatrics 2003; 111:1394.
  4. Coticchia JM, Getnick GS, Yun RD, Arnold JE. Age-, site-, and time-specific differences in pediatric deep neck abscesses. Arch Otolaryngol Head Neck Surg 2004; 130:201.
  5. Nolting L, Singer J, Hackett R, Kleiner L. Acute hematogenous osteomyelitis of the odontoid process in a child with torticollis. Pediatr Emerg Care 2010; 26:669.
  6. Cushing AH. Diskitis in children. Clin Infect Dis 1993; 17:1.
  7. Tracy MR, Dormans JP, Kusumi K. Klippel-Feil syndrome: clinical features and current understanding of etiology. Clin Orthop Relat Res 2004; :183.
  8. Nishimoto Y, Koga M, Yuki N. Neck stiffness in two children with Guillain-Barré syndrome after Campylobacter jejuni infection. J Neurol 2001; 248:1104.
  9. Hicazi A, Acaroglu E, Alanay A, et al. Atlantoaxial rotatory fixation-subluxation revisited: a computed tomographic analysis of acute torticollis in pediatric patients. Spine (Phila Pa 1976) 2002; 27:2771.
  10. Edlow JA. Diagnosis of subarachnoid hemorrhage in the emergency department. Emerg Med Clin North Am 2003; 21:73.
  11. Vural C, Gungor A, Comerci S. Accuracy of computerized tomography in deep neck infections in the pediatric population. Am J Otolaryngol 2003; 24:143.
  12. U-King-Im JM, Koo B, Trivedi RA, et al. Current diagnostic approaches to subarachnoid haemorrhage. Eur Radiol 2005; 15:1135.