Congenital torticollis

Last reviewed: 1 Sep 2022
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
Other diagnostic factors

Risk factors

  • plagiocephaly
  • breech delivery
  • cesarean section delivery
  • twin A (lower in utero)
  • complicated deliveries (forceps or vacuum)
  • birth trauma
More risk factors

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

ONGOING

inadequate head control or age <5 months

good head control and age >5 months

Contributors

Authors

Joyce L. Oleszek, MD
Joyce L. Oleszek

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.

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