Image Quiz
A Four-Year-Old Boy with Headache and Neck Stiffness1
In April 1993, a very active four-year and nine-month-old boy was seen at a hospital in another state because of headache and neck stiffness. No injury was reported at that time. He underwent magnetic resonance imaging of the brain and serum testing for C-reactive protein. The magnetic resonance imaging scan revealed normal findings, and the C-reactive protein level was within normal limits.
Two weeks later, he was seen in the emergency department of a local hospital with a very stiff neck. The neurological examination revealed normal findings, as did the radiographic skeletal survey. Cutaneous signs of child abuse were absent. The mother reported that acute neck pain and stiffness had developed in the child two to three weeks earlier. However, for the past year, the boy had experienced short-lasting episodes of intermittent neck pain that spontaneously resolved. A lateral radiograph of the cervical spine was made.
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