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Congenital muscular torticollis concurrent with sagittal synostosis: a case report.

Kim SH, Ahn AR, Yim SY - Ann Rehabil Med (2014)

Bottom Line: During clinical examination, prominent right sternocleidomastoid muscle and limited range of motion of the neck were noted, and right CMT was confirmed by magnetic resonance imaging of the neck.Thus, we report the first case that showed concurrence of CMT and sagittal synostosis.We recommend that concurrently manifested craniosynostosis needs to be examined if the subject with CMT displays unusual craniofacial asymmetry to a greater extent than deformational plagiocephaly.

View Article: PubMed Central - PubMed

Affiliation: The Clinic for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT
Congenital muscular torticollis (CMT) and craniosynostosis are diseases that cause plagiocephaly and craniofacial asymmetry in children. In our literature review, we did not find any report of concurrent manifestation of CMT and craniosynostosis. A 41-month-old boy visited our hospital with left torticollis, right laterocollis, and craniofacial asymmetry as the main findings. During clinical examination, prominent right sternocleidomastoid muscle and limited range of motion of the neck were noted, and right CMT was confirmed by magnetic resonance imaging of the neck. Three-dimensional computed tomography of the skull, which was conducted due to the unusual appearance of the skull with a large head circumference, mild brachycephaly, as well as left plagiocephaly, revealed premature closure of the sagittal suture. Thus, we report the first case that showed concurrence of CMT and sagittal synostosis. We recommend that concurrently manifested craniosynostosis needs to be examined if the subject with CMT displays unusual craniofacial asymmetry to a greater extent than deformational plagiocephaly.

No MeSH data available.


Related in: MedlinePlus

A 41-month-old boy shows (A) sternal (solid arrow) and clavicular (dotted arrow) heads of the right sternocleidomastoid muscle, which are more prominent than those on the left side (short arrows). (B) Measurement of the range of motion for cervical rotation shows a 30° deficit in the cervical rotation to the right side and (C) a 30° deficit in lateral flexion to the left side compared with that on the contralateral side.
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Figure 1: A 41-month-old boy shows (A) sternal (solid arrow) and clavicular (dotted arrow) heads of the right sternocleidomastoid muscle, which are more prominent than those on the left side (short arrows). (B) Measurement of the range of motion for cervical rotation shows a 30° deficit in the cervical rotation to the right side and (C) a 30° deficit in lateral flexion to the left side compared with that on the contralateral side.

Mentions: A 41-month-old boy visited our hospital with left torticollis, right laterocollis and craniofacial asymmetry as the main findings. He was born through a normal vaginal delivery at full term. Pregnancy and delivery were uncomplicated. Clinical examination revealed prominence of both sternal and clavicular heads of the right SCM (Fig. 1A) along with limited range of motion of the neck (Fig. 1B, 1C). Plagiocephaly on the left occiput (Fig. 2B) was evident with 20 mm of diagonal difference, which is defined as the difference between 2 diagonal cranial diameters, and anterior displacement of the left ipsilateral ear. Flat right zygomatic arch (Fig. 2B) was also observed. While the child's height and weight were 103 cm (75-90th percentile) and 17.9 kg (75-90th percentile), respectively, the head circumference was 54 cm (>97th percentile). The cephalic index, which is defined as the maximum skull breadth divided by the maximum AP length, was 87%, evidencing the presence of brachycephaly (normal range, 76%-85%) [3]. Developmental history was not particularly remarkable since the child began to walk without any assistance at the age of 12 months. The full scale of intellectual quotient and social maturity quotient of the child at 41 months of age were 93 and 105.8, respectively.


Congenital muscular torticollis concurrent with sagittal synostosis: a case report.

Kim SH, Ahn AR, Yim SY - Ann Rehabil Med (2014)

A 41-month-old boy shows (A) sternal (solid arrow) and clavicular (dotted arrow) heads of the right sternocleidomastoid muscle, which are more prominent than those on the left side (short arrows). (B) Measurement of the range of motion for cervical rotation shows a 30° deficit in the cervical rotation to the right side and (C) a 30° deficit in lateral flexion to the left side compared with that on the contralateral side.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4221403&req=5

Figure 1: A 41-month-old boy shows (A) sternal (solid arrow) and clavicular (dotted arrow) heads of the right sternocleidomastoid muscle, which are more prominent than those on the left side (short arrows). (B) Measurement of the range of motion for cervical rotation shows a 30° deficit in the cervical rotation to the right side and (C) a 30° deficit in lateral flexion to the left side compared with that on the contralateral side.
Mentions: A 41-month-old boy visited our hospital with left torticollis, right laterocollis and craniofacial asymmetry as the main findings. He was born through a normal vaginal delivery at full term. Pregnancy and delivery were uncomplicated. Clinical examination revealed prominence of both sternal and clavicular heads of the right SCM (Fig. 1A) along with limited range of motion of the neck (Fig. 1B, 1C). Plagiocephaly on the left occiput (Fig. 2B) was evident with 20 mm of diagonal difference, which is defined as the difference between 2 diagonal cranial diameters, and anterior displacement of the left ipsilateral ear. Flat right zygomatic arch (Fig. 2B) was also observed. While the child's height and weight were 103 cm (75-90th percentile) and 17.9 kg (75-90th percentile), respectively, the head circumference was 54 cm (>97th percentile). The cephalic index, which is defined as the maximum skull breadth divided by the maximum AP length, was 87%, evidencing the presence of brachycephaly (normal range, 76%-85%) [3]. Developmental history was not particularly remarkable since the child began to walk without any assistance at the age of 12 months. The full scale of intellectual quotient and social maturity quotient of the child at 41 months of age were 93 and 105.8, respectively.

Bottom Line: During clinical examination, prominent right sternocleidomastoid muscle and limited range of motion of the neck were noted, and right CMT was confirmed by magnetic resonance imaging of the neck.Thus, we report the first case that showed concurrence of CMT and sagittal synostosis.We recommend that concurrently manifested craniosynostosis needs to be examined if the subject with CMT displays unusual craniofacial asymmetry to a greater extent than deformational plagiocephaly.

View Article: PubMed Central - PubMed

Affiliation: The Clinic for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea.

ABSTRACT
Congenital muscular torticollis (CMT) and craniosynostosis are diseases that cause plagiocephaly and craniofacial asymmetry in children. In our literature review, we did not find any report of concurrent manifestation of CMT and craniosynostosis. A 41-month-old boy visited our hospital with left torticollis, right laterocollis, and craniofacial asymmetry as the main findings. During clinical examination, prominent right sternocleidomastoid muscle and limited range of motion of the neck were noted, and right CMT was confirmed by magnetic resonance imaging of the neck. Three-dimensional computed tomography of the skull, which was conducted due to the unusual appearance of the skull with a large head circumference, mild brachycephaly, as well as left plagiocephaly, revealed premature closure of the sagittal suture. Thus, we report the first case that showed concurrence of CMT and sagittal synostosis. We recommend that concurrently manifested craniosynostosis needs to be examined if the subject with CMT displays unusual craniofacial asymmetry to a greater extent than deformational plagiocephaly.

No MeSH data available.


Related in: MedlinePlus