Torticollis

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Torticollis

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Torticollis

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Torticollis

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A 2-month-old infant boy is evaluated for the first time since delivery. The patient was born at 40 weeks gestation via vaginal delivery and had a normal prenatal and postnatal birth history. He feeds 2-3 oz of breastmilk and formula every 2-3 hours. He is in the 75th percentile for height, 75th percentile for weight, and 50th percentile for head circumference. On physical examination, there is prominent head posturing. The head is tilted to the right side, and the chin is rotated to the left shoulder. A mass is palpable in the inferior portion of the neck on the right side. The mass is firm and does not transilluminate with a penlight. The rest of the physical examination, including the reflexes and muscular tone of the extremities, is normal. Which of the following is the most likely cause of this patient’s condition?  

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Torticollis p. 537

Summary

Torticollis is a condition characterized by the involuntary contraction of the neck muscles, causing the head to tilt to one side and turn to the other. There are several types of torticollis, but the most common is congenital, which occurs due to the shortening or tightness of the sternocleidomastoid muscle on one side of the neck, caused by abnormal positioning in the womb or trauma during delivery.

Common symptoms of torticollis include a tilted head to one side, limited neck range of motion, neck pain and stiffness, shoulder elevation on one side, and headache. The treatment of torticollis depends on the underlying cause and can include options like physical therapy, muscle relaxants, and botulinum toxin injections.

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