A 13-year-old female patient presented in the orthopedic department with chief complaints of pain in neck, difficulty in walking, and difficulty in deglutition for2 months. General physical examinations were within normal limits except posterior cervical lymphadenopathy. On further examination, she had cervical tenderness along with grossly normal power in all four limbs with exaggerated reflexes and planter upgoing. Blood investigations were done which showed raised ESR along with raised lymphocyte count and rest parameters were within normal limits. X-rays were done which showed destruction at C1-C2 level with increased prevertebral shadow. CT was done which also showed destructive lesion in C1 vertebra [Figure 5].
Clinicoradiologically diagnosis was made of tuberculosis, and the patient was started on ATT Category 1 and head halter traction was given for 3 months. ENT opinion was also taken regarding difficulty in deglutition but conservative treatment was planned.
The patient was serially followed and at 1-year followup, she has no complaint in neck or difficulty in walking, but on the protrusion of tongue, there is deviation of tongue to the left side [Figure 6].