Hospital For Special Surgery: Ultrasound of the Month - Case 30

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

Ultrasound of the Month – Case 30

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Ultrasound of the Month – Case 30

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Ultrasound of the Month – Case 30

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Ultrasound of the Month – Case 30

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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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