Last reviewed: 30 Sep 2024
Last updated: 07 Apr 2022
Summary
Definition
History and exam
Other diagnostic factors
- twin birth
- unnvaried 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 mass
- ipsilateral shoulder elevation
- plagiocephaly/craniofacial asymmetry
- hypertropia on contralateral side
- hip click or asymmetry
Full details
Risk factors
- plagiocephaly
- breech delivery
- cesarean section delivery
- twin A (lower in utero)
- complicated deliveries (forceps or vacuum)
- birth trauma
Full details
Diagnostic tests
1st tests to order
- cervical spine x-ray
- pelvic x-ray
- hip ultrasound
Full details
Tests to consider
- neck ultrasound
- skull x-ray
- cervical/cranial MRI
Full details
Treatment algorithm
ONGOING
inadequate head control or age <5 months
good head control and age >5 months
Contributors
Authors
Joyce L. Oleszek, MD
Associate Professor
Department of Physical Medicine and Rehabilitation
University of Colorado School of Medicine and The Children's Hospital Colorado
Aurora
CO
Disclosures
JLO is co-author of one of the references cited in this topic.
Peer reviewers
Elizabeth A. Moberg-Wolff, MD
Associate Professor
Program Director
Tone Management and Mobility
Children's Hospital of Wisconsin
Milwaukee
WI
Disclosures
EAMW declares that she has no competing interests.
Differentials
- Superior oblique palsy
- Central nervous system tumor
- Vertebral anomaly
More DifferentialsGuidelines
- Physical therapy management of congenital muscular torticollis
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