Which symptom would indicate atlantoaxial instability in a symptomatic child with Down syndrome?

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Multiple Choice

Which symptom would indicate atlantoaxial instability in a symptomatic child with Down syndrome?

Explanation:
In Down syndrome, instability at the C1–C2 junction can occur due to ligamentous laxity and cervical anatomy differences. When this instability becomes symptomatic, the hallmark sign is neck pain with torticollis—painful neck movement paired with an abnormal head tilt. This combination reflects abnormal movement and irritation at the upper cervical spine. Abdominal pain, fever, or hearing loss are not typical indicators of atlantoaxial instability and would point to other problems. If instability is suspected, it warrants careful evaluation and appropriate imaging to prevent potential spinal cord injury.

In Down syndrome, instability at the C1–C2 junction can occur due to ligamentous laxity and cervical anatomy differences. When this instability becomes symptomatic, the hallmark sign is neck pain with torticollis—painful neck movement paired with an abnormal head tilt. This combination reflects abnormal movement and irritation at the upper cervical spine. Abdominal pain, fever, or hearing loss are not typical indicators of atlantoaxial instability and would point to other problems. If instability is suspected, it warrants careful evaluation and appropriate imaging to prevent potential spinal cord injury.

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