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Musculoskeletal/Small parts » Musculoskeletal
Congenital muscular torticollis
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Author(s) :
Shlomo Gobi
 
Presentation A 6 month old baby presented with a head tilt. The clinical diagnosis was obvious, however an ultrasound of the neck was performed to confirm the diagnosis.
 
 
 
Caption: Longitudinal scan of left side of the neck
Description: This image shows a thickened left sternocleidomastoid muscle.
 
 
 
Caption: Longitudinal scan of right side of the neck
Description: The right sternocleidomastoid muscle appears normal.
 
 
 
Caption: Transverse scan of left side of the neck
Description: The thickened left sternocleidomastoid muscle stands out prominently in this image.
 
 
 
Caption: Comparative view of both the sides of the neck
Description: This view compares the sternocleidomastoid muscle on both the sides. The thickened left sternocleidomastoid demonstrates a mildly heterogeneous echotexture.
 
Differential Diagnosis Congenital muscular torticollis
 
Final Diagnosis Congenital muscular torticollis
 
Discussion The most important point to be remembered in young babies presenting with torticollis is its association with developmental dysplasia of the hip [DDH]. Hence babies presenting with congenital muscular torticollis should be screened for DDH.
 
Case References 1. http://www.posna.org/index?service=page/corecurriculum&article=torticollis.html 
2. http://www.dynomed.com/encyclopedia/encyclopedia/pediatric_orthopedics/congenital_muscular_torticollis.html 
3. Karapinar L, Surenkok F, Ozturk H, US, MR, Yurdakul L. The importance of predicted risk factors in developmental hip dysplasia: an ultrasonographic screening program. ACTA Orthop Traumatol Turc. 2002;36(2):106-10.
 
Follow Up An ultrasound was performed for this baby as screening for DDH. The study was normal.
 
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