Resumen
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
Other diagnostic factors
- nascimento de gêmeos
- posição supina para dormir e de repouso sem variação
- diminuição do tempo na posição pronada durante a vigília
- inclinação da cabeça
- cabeça virada com rotação ativa reduzida para o lado afetado
- endireitamento da cabeça reduzido para o lado contralateral
- massa no esternocleidomastoideo
- elevação do ombro ipsilateral
- plagiocefalia/assimetria craniofacial
- hipertropia no lado contralateral
- clique ou assimetria do quadril
Risk factors
- plagiocefalia
- parto pélvico
- parto cesáreo
- gêmeo A (na parte mais inferior do útero)
- partos complicados (fórceps ou vácuo)
- trauma no nascimento
Diagnostic investigations
1st investigations to order
- raio-X da coluna cervical
- radiografia pélvica
- ultrassonografia do quadril
Investigations to consider
- ultrassonografia do pescoço
- radiografia do crânio
- ressonância nuclear magnética (RNM) cervical/do crânio
Treatment algorithm
controle da cabeça inadequado ou idade <5 meses
bom controle da cabeça e idade >5 meses
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Cheng JC, Wong MW, Tang SP, et al. Clinical determinants of the outcome of manual stretching in the treatment of congenital muscular torticollis in infants. A prospective study of eight hundred and twenty-one cases. J Bone Joint Surg Am. 2001;83-A(5):679-87. Abstract
Cheng JC, Au AW. Infantile torticollis: a review of 624 cases. J Pediatr Orthop. 1994;14:802-808. Abstract
Binder H, Eng GD, Gaiser JF, et al. Congenital muscular torticollis: results of conservative management with long-term follow-up in 85 cases. Arch Phys Med Rehabil. 1987 Apr;68(4):222-5. Abstract
Positioning and sudden infant death syndrome (SIDS): update. American Academy of Pediatrics Task Force on Infant Positioning and SIDS. Pediatrics. 1996;98:1216-1218. Abstract
Emery C. The determinants of treatment duration for congenital muscular torticollis. Phys Ther. 1994 Oct;74(10):921-9.Full text Abstract
Cheng JC, Tang SP, Chen TM, et al. The clinical presentation and outcome of treatment of congenital muscular torticollis in infants - a study of 1,086 cases. J Pediatr Surg. 2000 Jul;35(7):1091-6. Abstract
Cheng JC, Tang SP. Outcome of surgical treatment of congenital muscular torticollis. Clin Orthop Relat Res. 1999 May;(362):190-200. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Paralisia do músculo oblíquo superior
- Tumor do sistema nervoso central
- Anomalia vertebral
More DifferentialsGuidelines
- Physical therapy management of congenital muscular torticollis
More Guidelines
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