TY - JOUR T1 - A pain in the neck JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 79 LP - 80 DO - 10.1136/edpract-2012-302955a VL - 98 IS - 2 AU - Ayeshea Zacharkiw AU - Helen Williams Y1 - 2013/04/01 UR - http://ep.bmj.com/content/98/2/79.abstract N2 - From questions on page 71. The correct answer is C; langerhans cell histiocytosis (LCH). The second lateral cervical spine radiograph shows complete collapse of C3 vertebral body (figure 4, arrowed), also called a vertebra plana, with abnormal vertebral alignment indicating cervical spine instability. Figure 4 LCH is a non-neoplastic proliferative disorder of histiocytes/dendritic cells (Langerhans cells being the histiocytes limited to skin). Clinical presentation can vary widely and LCH has historically been described as a number of different entities such as eosinophilic granuloma, Hand-Schüller-Christian disease and Letterer-Siwe disease often just representing the extent of organs/tissues involved. Treatment of LCH is based on risk stratification dependent on the extent of disease at presentation, namely; single bony-site, multiple bony-site or multisystem (multiorgan) involvement. Significant mortality is associated with multisystem disease in patients aged less than 2 years. Patients with only bone involvement have the best prognosis. LCH is seen from birth … ER -