Neonatology Book

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Torticollis

Aka: Torticollis
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  1. 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 ROM at birth
  2. Pathophysiology
    1. Unilateral shortening of sternocleidomastoid muscle
  3. Associated Conditions
    1. Congenital asymmetric contractures of hip abductors
    2. Unilateral Congenital Hip dysplasia
    3. Unilateral Metatarsus Adductus
  4. 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
  5. Images
    1. NeckLateralMuscles.jpg
  6. 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
  7. 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
  8. 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

Torticollis (C0040485)

Definition (MSH) A symptom, not a disease, of a twisted neck. In most instances, the head is tipped toward one side and the chin rotated toward the other. The involuntary muscle contractions in the neck region of patients with torticollis can be due to congenital defects, trauma, inflammation, tumors, and neurological or other factors.
Definition (CSP) contracted state of the cervical muscles, producing twisting of the neck and an unnatural position of the head.
Concepts Sign or Symptom (T184)
MSH D014103
ICD9 723.5
ICD10 M43.6
SnomedCT 156643008, 268080005, 202766007, 161883001, 139139001, 267978004, 267979007, 70070008, 270476009, 202769000, 275310009
English Torticollis, Wryneck, TORTICOLLIS, WRYNECK, Contracture of neck, NOS, Torticollis, NOS, Torticollis NOS, Torticollis unspecified, Torticollis, unspecified, wryneck, torticollis, torticollis (diagnosis), Torticollis (& [NOS]) (disorder), (Torticollis unspecified) or (contracture of neck) (disorder), Wry neck/torticollis (& symptom) (finding), Wry neck/torticollis (finding), contracture of neck, contracture of neck (diagnosis), Torticollis unspecified (disorder), Torticollis NOS (disorder), Torticollis [Disease/Finding], neck contracture, retrocollis, torticollis unspecified, Retrocollis, Wry neck, Contracture of neck, Wry neck/torticollis, Torticollis (disorder), Wry neck/torticollis (disorder), Contracture of neck (finding), (Torticollis unspecified) or (contracture of neck), Torticollis (& [NOS]), Torticollis - symptom, Wry neck symptom, Wry neck/torticollis (& symptom), wry neck
French TORTICOLIS, Torticolis, non précisé, Rétrocolis, Torticolis
Portuguese TORCICOLO, Torcicolo NE, Retrocolo, Torcicolo
Spanish TORTICOLIS, tortícolis, no especificado (trastorno), tortícolis, no especificado, Torcedura de cuello, Retrocolis, Tortícolis no especificada, tortícolis, no especificada (trastorno), tortícolis, no especificada, Torticollis NOS, Wry neck symptom, Torticollis unspecified, Wry neck/torticollis, Torticollis (& [NOS]), Wry neck, Torticollis, (Torticollis unspecified) or (contracture of neck), Wry neck/torticollis (& symptom), Torticollis - symptom, Contracture of neck, contractura del cuello, cuello torcido/tortícolis (trastorno), cuello torcido/tortícolis, tortícolis (trastorno), tortícolis, SAI (trastorno), tortícolis, SAI, tortícolis, contractura de cuello (hallazgo), contractura de cuello, Torticolis, Tortícolis
Dutch retrocollis, niet-gespecificeerde torticollis, scheefhals, scheve hals, torticollis, Scheve hals, Torticollis
German schiefer Hals, Retrocollis, Torticollis, unspezifisch, SCHIEFHALS, Torticollis, Schiefhals, Tortikollis
Italian Torcicollo posteriore, Contrattura dei muscoli del collo, Contrattura muscolare del collo, Torcicollo non specificato, Torcicollo
Japanese 斜頚、詳細不明, 後屈斜頚, ｼｬｹｲｼｮｳｻｲﾌﾒｲ, ｺｳｸﾂｼｬｹｲ, ｼｬｹｲ, 斜頚, 斜頸
Swedish Nackspärr
Czech tortikolis, Krutihlav, Blíže neurčená tortikolis, Retrokolis, Tortikolis, Zkroucený krk
Finnish Kierokaula
Russian KRIVOSHEIA, КРИВОШЕЯ
Korean 기운 목
Croatian TORTIKOLIS
Polish Kręcz karku
Hungarian Retrocollis, Torticollis, Torticollis, nem meghatározott, Ferdenyak, Nyakferdülés
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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