The neck

The neck:
Symptoms:
pain: in the neck &referred to the shoulder or arms.
Stiffness; deformity; neural deficit: numbness &weakness
in upper limbs(root pressure) or lower limbs(cord pressure).
Signs:
look? neck deformity; feel? tenderness;
move: flexion, extension, lateral flexion &rotation.
Neurological exam.: muscle power, reflexes &sensation.
Imaging:
X-ray: AP, Lat. &open mouth view(to see upper 2 vert.).
Lat. view: see 7 vertebrae with normal cervical lordosis.
CT? shows bony structures; MRI? discs,
neural structures, tumor &infection.

Deformities of the neck in children
Torticollis: the chin is twisted up &to one side.
It is either congenital or acquired.
Infantile(congenital) torticollis: it is common.
The cause is unknown(may be birth injury or abnormal position in utero).
At birth a lump in the sternomastoid is noticed on one side remaining for few months then disappears; after the first year, the muscle starts to become fibrous pulling the head to one shoulder. With time the deformity ? leading to asymmetrical development of the face(plagiocephaly).
??? bony anomaly, fracture, discitis & lymphadenitis.
?: during infancy? daily muscle stretching; if persist
beyond 1year? surgical division of contracted muscle at
lower or upper end or both ? rigid collar &stretching exercise.

Acquired (secondary) torticollis: may be secondary to:
congenital bone anomaly, trauma, infection( tonsillitis,
lymphadenitis, discitis, TB), ocular dysfunction.
Klippel-Feil syndrome: congenital fusion of 2 or more cervical
vertebra ? short neck with limitation of movement.