Presentation
The overall incidence of torticollis was 1.9%; 1.2% in cephalic presentations, 6.5% in double breech presentations, 4.2% in footling presentations and 34.0% in single (frank) breech presentations. [ncbi.nlm.nih.gov]
The median age at presentation is 2 months. The characteristic head tilt seen in this pathology is caused by abnormal contracture of the sternocleidomastoid muscle. [posna.org]
Entire Body System
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Crying
Your baby may move and squirm or cry. But doing them may help the baby get better. If you are unsure how to do the exercises or think you are hurting your baby, talk to your doctor. [myhealth.alberta.ca]
Role of Patient/Parent Preferences: During testing, parents may perceive that the baby experiences discomfort or that testing positions could potentially harm the baby, resulting in requests to stop testing if the baby is crying. [journals.lww.com]
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Soft Tissue Mass
Glasier CM, Seibert JJ, Williamson SL, Corbitt SL, Rodgers AB, Lange TA (1987) High resolution ultrasound characterization of soft tissue masses in children. Pediatr Radiol 17: 233–237 PubMed Google Scholar 10. [link.springer.com]
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Weight Loss
A team approach to your spinal problems may include physical therapy, medication, exercise, weight loss and therapeutic spinal injections. [mendelsonortho.com]
Respiratoric
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Respiratory Insufficiency
An infant with congenital torticollis underwent chiropractic manipulation, and within a few hours had respiratory insufficiency, seizures, and quadriplegia. [ncbi.nlm.nih.gov]
Musculoskeletal
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Torticollis
The incidence of congenital torticollis in association with plagiocephaly is 1 in 300 newborns, with the torticollis resulting from pathologically sustained contraction of the sternocleidomastoid. [ncbi.nlm.nih.gov]
Face, Head & Neck
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Neck Mass
Fine-needle aspiration biopsy, used extensively for evaluating head and neck masses in adults, also provides an excellent minimally invasive means of evaluating infants with neck masses and torticollis. [ncbi.nlm.nih.gov]
mass or cyst findings contracted muscle tissue in the case of congenital torticollis cystic or solid mass in the case of a congenital neck mass Differential Congenital neck mass cysts and tumors can be distinguished from a contracted SCM by ultrasound [step1.medbullets.com]
Kraus R, Han BK, Babcock DS, Oestreich AE (1985) Sonography of neck masses in children. AJR 146: 609–613 Google Scholar 9. [link.springer.com]
Neurologic
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Rotary Nystagmus
An 18-month-old infant with torticollis was referred for postural imbalance and observed rotary nystagmus. The infant had undergone physical therapy treatment of left torticollis for nearly 15 months. [ncbi.nlm.nih.gov]
Workup
Physical therapists should obtain copies of all images and interpretive reports, completed for the diagnostic workup of an infant suspected of having or diagnosed with CMT, to inform prognosis. [journals.lww.com]
Treatment
Adherence was measured by attendance, exercise compliance, and reason for treatment termination. [ncbi.nlm.nih.gov]
The mean treatment duration was 4.7 months (SD 5.06, range 1–36). Correlations were noted between severity of restriction and treatment duration (r .31) as well as between presence of a mass and treatment duration (r .26). [academic.oup.com]
Discussion: Several factors for a successful outcome of CMT were consistent through the literature, these included: proper diagnosis and early initiation of treatment, caregiver compliance with treatment, and consistency in treatment. [dspace.unm.edu]
Surgical treatment Surgical release may be considered in children older than 12-18 months of age with CMT resistant to conservative treatment or in case of facial asymmetry and plagiocephaly development [ 3, 20, 31 ] (Figure 2). [esciencecentral.org]
Prognosis
In light of the fact that the prognosis and, consequently, the treatment plan vary directly with the presence or absence of synostoses, clinical evaluation also includes cephalometrics, plain skull X-rays, and CT imaging. [ncbi.nlm.nih.gov]
It is a relatively common infantile deformity associated with typically favourable prognosis when early detected and treated. [esciencecentral.org]
Figure 2 is a flow diagram that can be used to guide practice and inform prognosis. [journals.lww.com]
Etiology
[…] unknown etiology but may be due to birth trauma or intrauterine malposition intrauterine compartment syndrome of the SCM muscle Pathoanatomy normal anatomy SCM muscle origins anterosuperior manubrium and medial clavicle insertion mastoid process of temporal [step1.medbullets.com]
Although "congenital" muscular torticollis is encountered frequently by pediatricians and orthopedic surgeons, there is no uniformity of thought as to its etiology or therapy. There is much confusion as to diagnosis. [jamanetwork.com]
[…] torticollis 3 Arnold-Chiari malformation 4 Atlantoaxial rotatory displacement 5 Paroxysmal torticollis of infancy ML 1 Select Answer to see Preferred Response PREFERRED RESPONSE 1 (OBQ09.2) Tightness in which of the following muscles has been implicated as an etiology [orthobullets.com]
Epidemiology
We analyzed epidemiological, obstetric, perinatal data, physical therapy, physician assessments, and clinical follow-up for two years after diagnosis. [ncbi.nlm.nih.gov]
Introduction Clinical definition "packaging deformity" caused by a contracture of the sternocleidomastoid (SCM) muscle "torticollis" is derived from Latin words " tortus " (crooked) and " collum " (neck) Epidemiology demographics most common cause of [step1.medbullets.com]
Epidemiology: Overall, the estimated incidence of congenital muscular torticollis is Clinical Findings: The typical head posture results from the contracted SCM: the ear on the side of contracture is tilted towards the ipsilateral shoulder while the chin [posna.org]
Sternocleidomastoid muscle Etiology/Epidemiology CMT occurs in 0.4 to 3.94% of births according to different sources [6] [4] [5]. It is the third most common musculoskeletal abnormality in infants [6] [1] [4]. [physio-pedia.com]
Pathophysiology
Pathophysiology Unilateral shortening of sternocleidomastoid muscle IV. Associated Conditions Congenital asymmetric contractures of hip abductors Unilateral Congenital Hip Dysplasia Unilateral Metatarsus Adductus V. [fpnotebook.com]
The right side was more commonly affected.[ 6 ] The etiology of CMT and pathophysiology behind SCM impairment is still unknown. [ncbi.nlm.nih.gov]
Role of the vestibular system in the pathophysiology of spasmodic torticollis. J Neurol Neurosurg Psychiatry. 2001 Sep. 71(3):285-8. [Medline]. Munchau A, Corna S, Gresty MA, et al. [emedicine.medscape.com]
Prevention
Counsel parents on the importance of “tummy time” in the treatment of CMT and prevention of positional plagiocephaly. Guide parents on strategies to treat CMT and prevent positional plagiocephaly. [pedsinreview.aappublications.org]
What can I do to prevent my baby from getting congenital muscular torticollis (CMT)? Sorry, but there’s no known prevention for CMT. [thebump.com]