Correlation of ultrasonographic imaging of congenital muscular torticolliswith clinical assessment in infants

Congenital muscular torticollis (CMT) is a common problem affecting infants and children. There is a general lack of standard clinical classification or objective assessment methods. Ultrasonographic imaging of the sternomast oid muscle (SCM) has been carried out in a consecutive series of 436 infant s less than 1 y old presenting with CMT over a 5-y period. All patients wer e classified into three clinical groups: postural torticollis, muscular tor ticollis and sternomastoid tumor. The severity of the torticollis was also expressed into four subgroups according to the degree of deficits in passiv e rotation of the neck. The ultrasonographic image of the affected SCM incl uded the echogenicity, texture, motility, softness and the transverse and l ongitudinal extent of the involvement. The disturbance in the quantitative measurement of the transverse diameter of the lower and upper third of the SCM and the ratio of the measurement to the normal side was recorded. The q ualitative and quantitative changes in the SCM image were found to correlat e significantly with the clinical typing and severity of rotational deficit s of the neck. Ultrasonographic imaging has important potential clinical ap plication in helping the diagnosis, prognostication and monitoring of progr ess of CMT longitudinally. (C) 2000 World Federation for Ultrasound in Medi cine & Biology.