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Torcicolo congênito

Última revisión: 25 Set 2025
Última actualización: 07 Abr 2022

Resumen

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
Full details

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
Full details

Risk factors

  • plagiocefalia
  • parto pélvico
  • parto cesáreo
  • gêmeo A (na parte mais inferior do útero)
  • partos complicados (fórceps ou vácuo)
  • trauma no nascimento
Full details

Diagnostic investigations

1st investigations to order

  • raio-X da coluna cervical
  • radiografia pélvica
  • ultrassonografia do quadril
Full details

Investigations to consider

  • ultrassonografia do pescoço
  • radiografia do crânio
  • ressonância nuclear magnética (RNM) cervical/do crânio
Full details

Treatment algorithm

ONGOING

controle da cabeça inadequado ou idade <5 meses

bom controle da cabeça e idade >5 meses

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.

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.

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