Pediatric Torticollis Surgery Workup

Updated: Mar 08, 2019
  • Author: Amulya K Saxena, MD, PhD, DSc, FRCS(Glasg); Chief Editor: Robert K Minkes, MD, PhD  more...
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Workup

Imaging Studies

Although the diagnosis of pediatric torticollis is easily made upon physical examination by an experienced clinician, ultrasonography (US) is the most commonly ordered test. [14, 15]

Magnetic resonance imaging (MRI) may be useful in patients with nonmuscular causes of torticollis; however, it is not recommended in asymptomatic patients with infantile torticollis. [16] Evaluation of MRI results correlated with histopathology has demonstrated that if multiple or large low signal intensities that represent increased fibrosis and aberrant dense connective tissue within the sternocleidomastoid are noted, a surgical release should be considered. [17]

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Histologic Findings

Histopathologic findings include fibrous replacement of skeletal muscle fibers that undergo atrophy. The degree of fibrosis and its extent or distribution may vary. Even in neonates, the fibrous tissue is mature. This finding indicates that the disease began before birth.

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