My Orthopaedic Surgeon

TORTICOLLIS CAUSED BY INTERVERTEBRAL DISC CALCIFICATION

- results from fibrosis of sternal head;
- can result from unilateral shortening of sternocleidomastoid, commonly associated with fibrosis of the muscle;
- may also involve the platysma and scalene muscles;
- birth trauma, occlussion of venous flow, or hematoma results in fibrosis of muscle & palpable mass noted w/in first 4 wks of life;
- nontender enlargement may be palpated in body of sternocleidomastoid
- mass usually resolves within the first year of life (90% resolve);
- management should include passive neck stretching
Wheeless' Textbook of Orthopaedics

Notes on working up the patient with Torticollis

Atlanta Case 17. The image is of an infant with torticollis. This is a clinical sign and not a diagnosis. The attitude of the head and neck results from a combination of head tilt and rotation. A tight sternomastoid muscle causes head tilt towards the tight side with rotation of the chin to the opposite side.
The differential diagnosis is extensive and important.

Torticollis is a condition that causes the neck to involuntarily twist to one side secondary to contraction of the neck muscles. The ear is tilted toward the contracted muscle and the chin is facing the opposite direction. Torticollis is derived from the Latin, tortus, meaning twisted and collum, meaning neck. It is a symptom of diverse conditions. Some of the more common causes include congenital problems, trauma, and infections.
Synonyms and related keywords: wryneck, spasmodic torticollis, cervical dystonia, loxia, congenital muscular torticollis, neck pain, twisted neck
Othee, Menckhoff & Pacelli 2008

Archive copy 2004