II. Etiologies

  1. Sternocleidomastoid muscle injury from Birth Trauma
    1. Hematoma and fibrosis results in muscle shortening
  2. Muscle adaptation from abnormal intrauterine position
  3. Cervical Vertebral abnormalities
    1. Suggested by limited neck range of motion at birth

III. Pathophysiology

  1. Unilateral shortening of sternocleidomastoid muscle

IV. Associated Conditions

  1. Congenital asymmetric contractures of hip abductors
  2. Unilateral Congenital Hip Dysplasia
  3. Unilateral Metatarsus Adductus

V. Signs

  1. Head Tilt toward the affected side
  2. Limited neck range of motion
    1. May suggest cervical Vertebral abnormality
  3. Face and skull asymmetry from lack of position change
  4. Palpable mass within sternocleidomastoid muscle
    1. Gradually disappears and is replaced by fibrous knot

VI. Images

VII. Radiology

  1. Neck XRay
    1. Indicated for significantly limited neck ROM
  2. Ultrasound Hips
    1. Assess for concurrent Congenital Hip Dysplasia
    2. Indicated for significant hip abductor tightness

VIII. Management

  1. Positioning head opposite affected side
    1. Padded bricks
    2. Sandbags
  2. Passive Stretching
    1. Rotate infants head to affected side
    2. Tilt head backwards (extend) away from affected side
  3. Surgical release of sternocleiodomastoid muscle
    1. Indicated for limited range of motion at 1 year

IX. Course

  1. Minimal signs at birth
  2. Torticollis evident by 2 to 3 weeks
  3. Recovery over 3 to 4 months with therapy
  4. Complete resolution by 1 year with therapy

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Ontology: Congenital torticollis (C0079352)

Concepts Congenital Abnormality (T019)
MSH C535425
ICD10 Q68.0
SnomedCT 123272007, 205041007, 25699004, 156999009, 268345004, 268240006
Spanish tortícolis congénito (trastorno), tortícolis congénito, trotícolis esternocleidomastoidea congénita, tortícolis congénita (trastorno), tortícolis congénita, tortícolis congénito del músculo esternomastoideo - RETIRADO - (concepto no activo), tortícolis congénito del músculo esternomastoideo - RETIRADO -, tortícolis esternomastoidea congénita (trastorno), tortícolis esternomastoidea congénita, contractura del músculo esternocleidomastoideo, tortícolis esternomastoidea congénita (concepto no activo), Tortícolis congénita
Italian Torcicollo congenito
German kongenitaler Torticollis
Japanese 先天性斜頚, センテンセイシャケイ
English Congen.sternomastoid torticol., Congenital torticollis, congenital torticollis, congenital torticollis (diagnosis), Congenital (sternomastoid) torticollis, Congenital contracture of sternocleidomastoid (muscle), Congenital muscular torticollis, Torticollis, congenital, torticollis congenital, Congenital sternomastoid torticollis (disorder), Torticollis -congenital, Congenital sternomastoid torticollis, Congenital wryneck, Contracture of sternocleidomastoid muscle, Congenital wry neck, Congenital torticollis (disorder), congenital; torticollis, contracture; sternocleidomastoid, sternocleidomastoid; contracture, torticollis; congenital, Congenital sternomastoid torticollis (disorder) [Ambiguous], Congenital sternomastoid torticollis -RETIRED-, Congenital contracture of sternocleidomastoid muscle, Congenital contracture of sternocleidomastoid
Czech Vrozená torticollis
Hungarian Veleszületett torticollis
Dutch congenitaal; torticollis, contractuur; sternocleidomastoideus, sternocleidomastoideus; contractuur, torticollis; congenitaal, torticollis, congenitaal
Portuguese Torcicolo congénito
French Torticolis congénital