Last reviewed: 25 Oct 2020
Last updated: 20 Nov 2018



History and exam

Other diagnostic factors

  • 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

Risk factors

  • plagiocephaly
  • breech delivery
  • caesarean section delivery
  • twin A (lower in utero)
  • complicated deliveries (forceps or vacuum)
  • birth trauma

Diagnostic investigations

1st investigations to order

  • cervical spine x-ray
  • pelvic x-ray
  • hip ultrasound
More 1st investigations to order

Investigations to consider

  • neck ultrasound
  • skull x-ray
  • cervical/cranial MRI
More investigations to consider

Treatment algorithm


Joyce L. Oleszek

Associate Professor

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.

Peer reviewersVIEW ALL

Associate Professor

Program Director

Tone Management and Mobility

Children's Hospital of Wisconsin




EAMW declares that she has no competing interests.

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