Congenital muscular torticollis (CMT) is the most common cause of torticollis in infancy. Neurologic disorders and osseous abnormalities, such as Klippel-Feil, are less common. Ultrasonography is considered the modality of choice for differentiating (CMT) from other more serious pathologies in the neck when a palpable mass is present. The initial treatment of of CMT is conservative, and good outcomes can be expected in the majority of these cases. Tang et al used US to examine affected sternocleidomastoid muscles in patients with CMT classified as having one of four types of fibrosis. They determined the change in fibrosis type over time and concluded that CMT is a dynamic disease which can be accurately assessed and followed by ultrasonography. Benign paroxysmal torticollis is a self-limiting condition occurring during infancy. It resolves by the age of two to three years. Paroxysmal torticollis of infancy is a rare disorder characterized by periodic episodes of torticollis which are associated with pallor, agitation and ataxia. The etiology is unknown and no treatment is effective, however the condition is usually benign and self-limiting.
Birch JG, ed. Instructional Course Lectures: Pediatrics. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2006:227-243.
Tang SF, Hsu KH, Wong AM, Hsu CC, Chang CH. Longitudinal followup study of ultrasonography in congenital muscular torticollis. Clin Orthop Relat Res. 2002 Oct;(403):179-85.
PMID:12360024 (Link to Abstract)