Torticollis Revealing Atlantoaxial Rotatory Subluxation in A Down Syndrome Patient

Atlantoaxial rotatory subluxation (AARS) is a rare condition, more frequently observed in pediatric populations and individuals with predisposing factors such as congenital syndromes. Patients with Down syndrome (trisomy 21) are at increased risk of cervical spine instability due to ligamentous laxity and bony anomalies. We report the case of a 17-year-old male patient with a known history of Down syndrome and ventricular septal defect, who was hospitalized for infective endocarditis. During his hospital stay, he developed an acute torticollis. Cervical radiography, computed tomography (CT), and magnetic resonance imaging (MRI) revealed a Fielding and Hawkins type II atlantoaxial rotatory subluxation. No recent trauma or upper respiratory infection was reported. The patient was managed successfully with conservative medical treatment.