Congenital torticollis: Difference between revisions
No edit summary |
No edit summary |
||
| Line 42: | Line 42: | ||
== Differential Diagnosis == | == Differential Diagnosis == | ||
*[http://www.physio-pedia.com/Adult-onset_Idiopathic_Torticollis Acquired torticollis]<ref name="1" /> | |||
*Occipitoatlantal Fusion: characterized by partial or total fusion of the atlas to the occipital bone. The altered mechanics of the cervical spine predisposes the atlantoaxial joint to degeneration and potential instability, resulting in a dull, aching pain in the posterior neck with intermittent stiffness and torticollis. MRI and CT with 3D reconstruction are necessary for diagnosing<ref name="1" />. | |||
*[http://www.physio-pedia.com/Klippel-Feil_syndrome Klippel-Feil syndrome]<ref name="1" /> | |||
*Sternomastoid tumor: there is a palpable mass on the sternocleidomastoid muscle, this must be conformed with ultrasonography<ref name="4" /> | |||
*[http://www.physio-pedia.com/Scoliosis Scoliosis]<ref name="8" /><br> | |||
== Diagnostic Procedures == | == Diagnostic Procedures == | ||
Revision as of 08:36, 19 June 2013
Original Editors
Top Contributors - Grace Barla, Nikki Rommers, Lucinda hampton, Jess Bell, Asma Alshehri, Admin, Lauren Kwant, Robin Tacchetti, Ahmed M Diab, Kim Jackson, Ceulemans Lisa, WikiSysop, Uchechukwu Chukwuemeka, Rucha Gadgil, Mila Andreew, 127.0.0.1 and Gaelle De Coster
Search Strategy[edit | edit source]
add text here related to databases searched, keywords, and search timeline
Definition/Description
Congenital torticollis or wry neck is a condition in infants detected at birth or shortly afterCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. It is characterized by rotational deformity of the cervical spine with secondary tilting of the head Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. There is a lateral head tilt to one side and contralateral rotationCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title[1]. It is most commonly the result of unilateral shortening and thickening or excessive contraction of the sternocleidomastoid muscle Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. The basic abnormality is known as endomysial fibrosis with deposition of collagen and migration of fibroblasts around individual muscle fibersCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. It leads to a limitation of the head mobility in both rotation and lateral flexion and progressive degrees of neck contractureCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Clinically Relevant Anatomy[edit | edit source]
The normal physiologic range of rotation of the atlas on the axis is 25o-53o degrees to either side. The transverse ligament is the primary stabilizer of the atlantoaxial joint and prevents excessive anterior motion of the atlas on the axis. It extends behind the dens, between the medial portions of the lateral masses of C1Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. The paired alar ligaments act as secondary stabilizers to prevent anterior shift. The alar ligaments extend from the lateral aspect of the dens tip to the medial aspect of the occipital condyles, with a lower portion attaching to the medial aspect of the lateral masses of C1Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
The sternocleidomastoid muscle has a sternal and clavicular head. The sternal head is directed from the manubrium sterni superiorly, laterally and posteriorly and the clavicular from the medial third of the clavicle vertically upward. It runs to the mastoid process. It enables an ipsilateral lateral flexion and a contralateral rotation. The muscle extends the upper part of the cervical spine and flexes the lower partCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Etiology/Epidemiology[edit | edit source]
Congenital torticollis occurs in 0.4 to 3.94% of births according to different sourcesCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. It is the third most common musculoskeletal abnormality in infantsCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
The true etiology remains controversialCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. So far more than 80 entities have been described that can cause torticollisCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. We can differentiate several frequent causes of congenital torticollis:
- Muscular in more than 80% of the casesCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title. Types muscular torticollis
- Fibromatosis colli: torticollis with palpable mass in the SCM;
- Tightness of the SCM without an apparent mass; - Postural torticollis with neither mass or tightnessCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title. - Birth trauma: facet dislocation, tears in the sternocleidomastoid muscle
- Congenital anomalies of the craniovertebral junction: occipitoatlantal fusion or Klippel-Feil syndromeCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid<ref>tag; name cannot be a simple integer. Use a descriptive title. - Sternocleidomastoid tumour Cite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title - Ocular abnormalitiesCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title - Intrauterine mechanical factorsCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid<ref>tag; name cannot be a simple integer. Use a descriptive title
A common hypothesis of muscular torticollis is that intrauterine constraint limits head mobility and leads to progressive degrees of neck contracture. The severity depends on the duration of prenatal immobilityCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. There is no difference in clinical severity based on the method of child birthCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Characteristics/Clinical Presentation[edit | edit source]
Congenital muscular torticollis is characterized by an unilateral contraction of the sternocleidomastoid muscle that forces the infant to hold the head tilted toward the affected side with slight rotation of the chin to the contra¬lateral sideCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.The affected side seems to be excessively stronger than the contralateral side. This causes an imbalance in the neck musclesCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. In some cases the shoulder is elevated on the affected sideCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
When congenital muscular torticollis is left untreated, it can cause fibrosis of the cervical musculature with progressive limitation of head movement, craniofacial asymmetry, and compensatory scoliosis that worsens with ageCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Differential Diagnosis[edit | edit source]
- Acquired torticollisCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title - Occipitoatlantal Fusion: characterized by partial or total fusion of the atlas to the occipital bone. The altered mechanics of the cervical spine predisposes the atlantoaxial joint to degeneration and potential instability, resulting in a dull, aching pain in the posterior neck with intermittent stiffness and torticollis. MRI and CT with 3D reconstruction are necessary for diagnosingCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title. - Klippel-Feil syndromeCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title - Sternomastoid tumor: there is a palpable mass on the sternocleidomastoid muscle, this must be conformed with ultrasonographyCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title - ScoliosisCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title
Diagnostic Procedures[edit | edit source]
add text here related to medical diagnostic procedures
Outcome Measures[edit | edit source]
add links to outcome measures here (also see Outcome Measures Database)
Examination[edit | edit source]
add text here related to physical examination and assessment
Medical Management
[edit | edit source]
add text here
Physical Therapy Management
[edit | edit source]
add text here
Key Research[edit | edit source]
add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Clinical Bottom Line[edit | edit source]
add text here
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10
References[edit | edit source]
see adding references tutorial.
- ↑ Petronic I., et al. Congenital muscular torticollis in children: distribution, treatment duration and outcome. European Journal of Physical and Rehabilitation Medicine. 2010; 45(2): 153-158 (Level of Evidence 2)
