Neck deformity that involves shortening of the sternocleidomastoid (SCM) muscle resulting in limited neck rotation and lateral flexion.
Infants tilt their head towards the side of the shortened muscle and rotate to the contralateral side.
Plagiocephaly and craniofacial deformities can be associated with congenital muscular torticollis (CMT) and can perpetuate one another.
Developmental hip dysplasia can be associated with CMT.
It is important to rule out non-muscular causes such as ocular, vertebral, and neurological.
Treatment includes carer education on positioning and physiotherapy; botulinum toxin type A injections or surgery are reserved for recalcitrant cases.
Congenital muscular torticollis (CMT) is a neck deformity that involves shortening of the sternocleidomastoid (SCM) muscle resulting in limited neck rotation and lateral flexion. This results in a head tilt to the affected side and rotation to the contralateral side.
History and exam
- twin birth
- non-varied supine sleep and resting position
- decreased prone awake time
- head tilt
- head rotated with decreased active rotation to affected side
- decreased head righting to contralateral side
- sternocleidomastoid (SCM) mass
- ipsilateral shoulder elevation
- plagiocephaly/craniofacial asymmetry
- hypertropia on contralateral side
- hip click or asymmetry
Joyce L. Oleszek, MD
Department of Physical Medicine and Rehabilitation
University of Colorado School of Medicine and The Children's Hospital Colorado
JLO is co-author of one of the references cited in this monograph.
Elizabeth A. Moberg-Wolff, MD
Tone Management and Mobility
Children's Hospital of Wisconsin
EAMW declares that she has no competing interests.
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