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Congenital Muscular Torticollis: Computed Tomographic Observations

John R. Sty, MD; Robert G. Wells, MD; Bruce A. Schroeder, MD
Am J Dis Child. 1987;141(3):243-244. doi:10.1001/archpedi.1987.04460030021011.
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Sir.—Three infants, aged 7, 9, and 11 months, who presented with left neck mass and torticollis were evaluated with computed tomography (CT). Roentgenograms demonstrated no structural abnormalities of the skull base or cervical spine. Computed tomography showed abnormal enlargement of the inferior aspect of the left sternocleidomastoid muscle (Figs 1 and 2). The area of enlargement was of the same CT attenuation as normal muscle. No calcifications were identified. One child received intravenous contrast material, and no abnormal enhancement occurred. On the basis of clinical evaluation, roentgenographic findings, CT findings, and response to therapy, the diagnosis of congenital muscular torticollis was made in each case.

The classic presentation of congenital muscular torticollis is easily recognized when present. The clinical findings include head tilt with the chin rotated, a tight sternocleidomastoid muscle, a restricted range of motion, facial asymmetry, and plagiocephaly.1 A mass or "tumor" may be palpable, representing

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