Torticollis in 16 month old

[susanelizabeth]

Thanks for reviewing my question.  All of a sudden my little guy's little head started leaning toward the right side, he is 16 mos. old.  He seems totally fine aside from that and this is totally new  The doc said it is probably due to the way he slept or some kind of strain on the muscle but I of course googled 'acquired torticollis' and I see very scary things like tumors and spinal cord issues...  (unlike congenital torticollis which is present in infants).  I am calling a physical therapist just because it is hard for me to get him to cooperate when I try to apply a heating pad to it and turn it slightly like the dr. told me.  His head is leaning toward the right side.  Is this likely to be due to a muscle spasm or a muscle tightening/sprain that he somehow got from an unknown injury? Is this common at all on an older child such as my son?  Or could this be indicative of a more major problem.  Thanks in advance for your help.

[Kevin Kennedy, Ph.D.]

Good. No, the imaging studies are safe.

[susanelizabeth]

Thank you, Dr.  Will MRI or radiograph be harmful to him in any way or is it ok in most cases?  My doctor said if the condition does not resolve w/in a week, she will refer us to a specialist.  So far it has not (since wed) but we have an appt with a Physical therapist for Monday, if we still cant correct this, I will definitely contact a specialist at the end of the week.

[Kevin Kennedy, Ph.D.]

The only way to pinpoint what is causing this symptom is by thorough evaluation. It would be wise to seek a second opinion, or to ask your son's pediatrician for referrals to appropriate specialties (e.g., neurology, ophthalmology) to determine the cause of the torticollis. As you have undoubtedly learned from your investigation, a number of conditions can result in this symptom. So it is wise not to assume anything, but to determine with precision what is occurring. It may be necessary to have some imaging studies (e.g., radiograph, MRI) to be able to tell. While the doctor's diagnosis may well turn out to be accurate, without more definitive investigation (unless he has already done the things I mentioned) it is impossible to know.