Atlantoaxial rotatory subluxation presenting as acute torticollis after mild trauma

Atlantoaxial rotatory subluxation (AARS) is a rare outcome of trauma in adults. We present a case of a 38-year-old female who presented with neck pain and stiffness after a mild trauma. On exam the patient had a “cock-robin” position, comparable to acute torticollis. Computerized tomography demonstrated findings consistent with AARS. Reduction was performed in the emergency department and the patient had no further neurological sequelae. Recognition of AARS after trauma requires a high index of suspicion and early diagnosis is important to best patient outcomes.