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A pain in the neck
  1. Ayeshea Zacharkiw,
  2. Helen Williams
  1. Radiology Department, Birmingham Children's Hospital, Birmingham, UK
  1. Correspondence to Dr Helen Williams, Radiology Department, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK; helen.williams{at}

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Theme: Neck

Select one option from the following:

  • A. Acute crush fracture

  • B. Infective spondylodiscitis

  • C. Langerhans Cell Histiocytosis

  • D. Pharyngotonsillitis

  • E. Retropharyngeal infection

  • F. Retropharyngeal tumour

  • G. Vertebral metastasis

Answers to the following two quiz questions can be found on page XXX


This 4-year-old boy presented to the emergency department with neck pain 1 week after falling over backwards. He was complaining of pain on neck extension but had a full range of neck movements. Cervical spine radiographs were obtained (lateral view from the series is shown in figure 1). He was reassured and sent home with pain relief. A month later he re-presented as the pain had not settled. On this occasion he was reluctant to move his neck, but was otherwise well. A second set of radiographs were taken. What is the most likely diagnosis based on the second lateral cervical spine radiograph? (figure 2)

Figure 1
Figure 2


This 8-year-old boy presented with a 24-h history of sore throat, painful swallowing, pyrexia, neck stiffness and pain. On examination he looked unwell, had palpable bilateral cervical lymph nodes which were tender and a temperature of 39.5°C. The patient was appropriately assessed by senior clinical staff. Acute airway …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.