[Rotary C1-C2 dislocation: a case report].
The atloid-axoid rotatory slipped disc is a rare pathology with still uncertain etiology. Many situations can be factors of this disease. We report a case in a child who was admitted to the hospital for a stiff neck that had been evolving for 1 month. The clinical examination found an irreducible angular deformity of the neck and multiple cervical adenopathies. The ORL examination was normal, the biological tests showed no disorders, and the X-ray examinations were also normal. Unexpected admission features were also disconcerting. The child suddenly presented a stiff neck on waking 2 days after a traditional circumcision at home, which might have been traumatizing. The mother also reported fever a few days before, attributed to rhinopharyngitis. Before his referral to the Rabat Children's Hospital, the child had received an anti-inflammatory treatment without any improvement. He had also been considered to have an opisthotonos on admission and was treated for suspected tetanus. Finally, the rotatory dislocation of C1-C2 was suggested, and a cervico-occipital junction scanner with three-dimensional reconstructions confirmed the diagnosis. The child was treated with cranial traction with good progression. This case opens the discussion of this rare disease, often unrecognized, which requires a multidisciplinary approach.
Service de pédiatrie III, hôpital d'Enfants, Rabat, Maroc. ettairsaid@yahoo.fr
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Ettair
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McHarfi
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Hssissen
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Meskini
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Erreimi
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Mouane
D001269:Atlanto-Occipital Joint / Q000000981:diagnostic imaging / Q000293:injuries*; D002574:Cervical Vertebrae / Q000293:injuries*; D002675:Child, Preschool; D002944:Circumcision, Male / Q000009:adverse effects; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology*; D008297:Male; D019637:Orthopedic Procedures; D012307:Risk Factors; D013742:Tetanus / Q000150:complications / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D014103:Torticollis / Q000209:etiology*; D014143:Traction / Q000379:methods; D016896:Treatment Outcome