Correlation of clinical and ultrasonographic features in congenital muscular torticollis.
OBJECTIVE
To find the relationship between the ultrasonographic pictures and the clinical features of patients with congenital muscular torticollis (CMT).


METHODS
Prospective survey of patients with clinically suspected CMT by high-resolution ultrasonography.


METHODS
Rehabilitation department of a tertiary care center.


METHODS
Two hundred fifty-six CMT patients, from the ages of 9 days to 16yrs, with a mean follow-up period of 6.7 months.


METHODS
Correlation of the ultrasound appearance of the involved sternocleidomastoid (SCM) muscles with clinical features. The pathologic findings in diseased muscles from patients who underwent surgical intervention were also evaluated.


RESULTS
Muscle abnormalities were identified ultrasonographically in 218 CMT patients (85%) and were classified into four types: a fibrotic mass in the involved muscle (type I, 15%); diffuse fibrosis mixing with normal muscle (type II, 77%) and without normal muscle in the involved muscle (type III, 5%); and a fibrotic cord in the involved muscle (type IV, 3%). Compared with type I patients, type IV patients were more likely to undergo surgical treatment (odds ratio = 31.54, p = .0196). Type III patients were more likely to undergo surgical treatment, although this tendency was not statistically significant.


CONCLUSIONS
Ultrasonography can precisely identify pathologic changes in the involved SCM muscle of CMT patients. Type III and IV patients are more likely to require surgical intervention.
Hsu
T C
TC
Department of Rehabilitation Medicine, Chang Gung Memorial Hospital, Taoyuan Hsien, Gueishan, Taiwan.
Wang
C L
CL
Wong
M K
MK
Hsu
K H
KH
Tang
F T
FT
Chen
H T
HT
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009334:Neck Muscles / Q000000981:diagnostic imaging* / Q000473:pathology; D011446:Prospective Studies; D014103:Torticollis / Q000151:congenital* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography