Clinical History •
1-month-old infant presents to his pediatrician with a palpable neck mass and torticollis
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There are no other physical examination findings
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The recent birth was complicated by a breech delivery
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Ultrasound of the Month – Case 30
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Diagnosis:
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Congenital Muscular Torticollis
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Congenital Muscular Torticollis •
Also referred to as sternocleidomastoid torticollis
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Secondary to a shortened and fibrosed sternocleidomastoid muscle
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May be secondary to birth trauma to the sternocleidomastoid muscle resulting in fibrosis
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May also be secondary to fetal malposition within the uterus
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Congenital Muscular Torticollis •
In 75% of patients, the condition involves the right sternocleidomastoid muscle
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Most common in first-born children
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Of note, there is an increased incidence of hip dysplasia in infants with congenital muscular torticollis
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Congenital Muscular Torticollis •
In the majority of patients, the process is self-limiting within the first year with no residual deformity. The need for physical therapy is controversial
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In 10% of patients, the condition may persist beyond one year with possible physical therapy and rarely surgical intervention necessary
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