This study was normal. Her behavior appeared to normalize and she was ambulating well. Her neck symptoms persisted. She was discharged from the emergency department. She recovered spontaneously without any complications.
Plain films are often difficult to interpret.
The patient may present with torticollis, which is usually due to benign muscle spasm often following a viral infection. Although most patients with torticollis do not have rotary subluxation, the task of deciding whom to evaluate further is difficult. CT scanning the cervical spine can more definitively assess the rotational relationships of the cervical spine elements and more effectively rule out rotary subluxation. Developmental variants of the cervical spine in young children can be difficult to deal with when interpreting radiographs using measurement parameters based on adults. The space between the atlas and the odontoid can be 4 to 5 mm in children up to age 15 years, compared to 2 mm for adults.