Diagnosis and management of torticollis.

Clearly, torticollis may stem from a variety of factors involving a number of primary structures -- bones, ligaments, muscles, and the nervous system. The crucial point is to differentiate torticollis that may lead to structural changes from that of a compensatory or functional nature. The key criterion is whether torticollis persists or resolves. This can be readily determined by treating torticollis initially with head halter traction of three to four pounds' weight and observing whether it resolves in five of seven days. If the torticollis and related symptoms persist beyond this time, the physician should consider possible lesions other than common rotary subluxation. Diagnosis of unresolved torticollis requires extensive and often repetitive investigation procedures. Perseverance in the diagnosis and management of persistent torticollis is a commendable virtue.