Pharynx and tonsils: Grisel syndrome: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Pharynx and tonsils: Grisel syndrome

Sample item

A 7-year-old develops severe neck pain and a fixed head tilt with rotation to one side after adenotonsillectomy for recurrent tonsillitis. There is no fever, and the neck is stiff but neurologically normal. Which diagnosis should be suspected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Atlantoaxial rotatory subluxation (Grisel syndrome)

Grisel syndrome is non-traumatic atlantoaxial rotatory subluxation following pharyngeal inflammation or ENT surgery, giving torticollis and neck pain. It is diagnosed by CT of the cervical spine and treated with traction and immobilisation, with delay risking fixed deformity.

Option by option

  • A. Atlantoaxial rotatory subluxation (Grisel syndrome) (correct)

    Correct. Painful torticollis after pharyngeal surgery in a child suggests atlantoaxial subluxation.

  • B. Retropharyngeal abscess

    Retropharyngeal abscess gives fever, dysphagia and drooling.

  • C. Meningitis

    Meningitis causes fever, photophobia and altered sensorium.

  • D. Congenital muscular torticollis

    Congenital muscular torticollis is present in infancy with a sternomastoid mass.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Atlantoaxial rotatory subluxation (Grisel syndrome). Grisel syndrome is non-traumatic atlantoaxial rotatory subluxation following pharyngeal inflammation or ENT surgery, giving torticollis and neck pain.

Why is "Retropharyngeal abscess" not the answer?

Retropharyngeal abscess gives fever, dysphagia and drooling.

Why is "Meningitis" not the answer?

Meningitis causes fever, photophobia and altered sensorium.

Why is "Congenital muscular torticollis" not the answer?

Congenital muscular torticollis is present in infancy with a sternomastoid mass.

What concept does this question test?

It tests Pharynx and tonsils: Grisel syndrome in ENT. It is diagnosed by CT of the cervical spine and treated with traction and immobilisation, with delay risking fixed deformity.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pharynx and tonsils: Grisel syndrome?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.