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    J Korean Soc Radiol. 2013 May;68(5):385-390. Korean.
    Published online May 20, 2013.
    https://doi.org/10.3348/jksr.2013.68.5.385
    Copyright © 2013 The Korean Society of Radiology
    Original Article

    Correlation between the Volume of a Lesion or Physical Training, and Regression Time, in Congenital Torticollis Patients

    Seong Jin Kim, MD and Dong Wook Kim, MD
      • Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
    • Corresponding author: Dong Wook Kim, MD. Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 614-735, Korea. Tel. 82-51-890-6549, Fax. 82-51-896-1085, Email: dwultra@lycos.co.kr
    Received December 27, 2012; Accepted March 22, 2013.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    This study aimed to evaluate any correlation between the volume of a lesion or physical training, and regression time, in congenital torticollis patients.

    Materials and Methods

    From January 2007 to December 2010, 63 infants and young children underwent neck ultrasound (US), as congenital torticollis was clinically suspected. We statistically analyzed the correlation between the volume of a lesion or physical training and the regression time, when successful regression was defined as no visible lesion on follow-up US, or no palpation of the lesion on clinical follow-up.

    Results

    Among 63 patients, 48 were sonographically diagnosed with congenital torticollis: normal delivery (n = 39) and c-sec (n = 9). Among them, 24 were clinically followed up, and 22 showed complete regression. Among 24 patients, 9 underwent physical training, and 7 showed complete regression after physical training. There was a negative correlation between the volume of a lesion and the regression time (p = 0.011), but there was no statistical significance between physical training and the regression time (p = 0.15).

    Conclusion

    In congenital torticollis patients, the volume of a lesion was in reverse proportion to the regression time, and physical training may be unhelpful for a decrease in regression time.

    Keywords
    Neck; Torticollis; Ultrasound; Regression

    Figures

    Fig. 1
    Successful regression of congenital muscular torticollis in 1-month-old boy.

    A, B. On initial neck ultrasound, longitudinal (A) and transverse (B) images show localized enlargement of sternocleidomastoid muscle and higher echogenicity than adjacent normal sternocleidomastoid muscle.

    C, D. On follow-up neck ultrasound obtained 5 months after physical therapy, longitudinal (C) and transverse (D) images show normal thickness and echogenicity of sternocleidomastoid muscle.

    Fig. 2
    Unsuccessful regression of congenital muscular torticollis in 4-month-old boy.

    A, B. On initial neck ultrasound, longitudinal (A) and transverse (B) images show localized enlargement of sternocleidomastoid muscle and higher echogenicity than adjacent normal sternocleidomastoid muscle.

    C, D. On follow-up neck ultrasound obtained 12 months after physical therapy, longitudinal (C) and transverse (D) images show slightly decreased lesion.

    Fig. 3
    Linear regression analysis between the volume of a muscular lesion and regression time in 24 patients.

    Tables

    Table 1
    Clinical Data, Echogenicity and Volume of Lesions, Physical Training, and Regression in 24 Patients

    References

      1. Ballock RT, Song KM. The prevalence of nonmuscular causes of torticollis in children. J Pediatr Orthop 1996;16:500–504.
      1. Binder H, Eng GD, Gaiser JF, Koch B. Congenital muscular torticollis: results of conservative management with long-term follow-up in 85 cases. Arch Phys Med Rehabil 1987;68:222–225.
      1. Cheng JC, Au AW. Infantile torticollis: a review of 624 cases. J Pediatr Orthop 1994;14:802–808.
      1. Cheng JC, Wong MW, Tang SP, Chen TM, Shum SL, Wong EM. Clinical determinants of the outcome of manual stretching in the treatment of congenital muscular torticollis in infants. A prospective study of eight hundred and twenty-one cases. J Bone Joint Surg Am 2001;83-A:679–687.
      1. Haque S, Bilal Shafi BB, Kaleem M. Imaging of torticollis in children. Radiographics 2012;32:557–571.
      1. Chan YL, Cheng JC, Metreweli C. Ultrasonography of congenital muscular torticollis. Pediatr Radiol 1992;22:356–360.
      1. Lin JN, Chou ML. Ultrasonographic study of the sternocleidomastoid muscle in the management of congenital muscular torticollis. J Pediatr Surg 1997;32:1648–1651.
      1. Cheng JC, Metreweli C, Chen TM, Tang S. Correlation of ultrasonographic imaging of congenital muscular torticollis with clinical assessment in infants. Ultrasound Med Biol 2000;26:1237–1241.
      1. Som P, Curtin H. In: Head and Neck Imaging. St. Louis: Mosby; 2011. pp. 2715-2718.
      1. Davids JR, Wenger DR, Mubarak SJ. Congenital muscular torticollis: sequela of intrauterine or perinatal compartment syndrome. J Pediatr Orthop 1993;13:141–147.
      1. Hollier L, Kim J, Grayson BH, McCarthy JG. Congenital muscular torticollis and the associated craniofacial changes. Plast Reconstr Surg 2000;105:827–835.
      1. Macdonald D. Sternomastoid tumour and muscular torticollis. J Bone Joint Surg Br 1969;51:432–443.
      1. Berlin H. The differential diagnosis and management of torticollis in children. Phys Med Rehabil Clin N Am 2000;14:197–206.
      1. Wei JL, Schwartz KM, Weaver AL, Orvidas LJ. Pseudotumor of infancy and congenital muscular torticollis: 170 cases. Laryngoscope 2001;111(4 Pt 1):688–695.
      1. Slate RK, Posnick JC, Armstrong DC, Buncic JR. Cervical spine subluxation associated with congenital muscular torticollis and craniofacial asymmetry. Plast Reconstr Surg 1993;91:1187–1195.
      1. Canale ST, Griffin DW, Hubbard CN. Congenital muscular torticollis. A long-term follow-up. J Bone Joint Surg Am 1982;64:810–881.
      1. Chang PY, Tan CK, Huang YF, Sheu JC, Wang NL, Yeh ML, et al. Torticollis: a long-term follow-up study. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1996;37:173–177.
      1. Cheng JC, Tang SP, Chen TM, Wong MW, Wong EM. The clinical presentation and outcome of treatment of congenital muscular torticollis in infants--a study of 1,086 cases. J Pediatr Surg 2000;35:1091–1096.
      1. Ippolito E, Tudisco C, Massobrio M. Long-term results of open sternocleidomastoid tenotomy for idiopathic muscular torticollis. J Bone Joint Surg Am 1985;67:30–38.
      1. Ho BC, Lee EH, Singh K. Epidemiology, presentation and management of congenital muscular torticollis. Singapore Med J 1999;40:675–679.
      1. Persing J, James H, Swanson J, Kattwinkel J. American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Plastic Surgery and Section on Neurological Surgery. Prevention and management of positional skull deformities in infants. American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Plastic Surgery and Section on Neurological Surgery. Pediatrics 2003;112(1 Pt 1):199–202.
      1. Yim SY, Lee IY, Park MC, Kim JH. Differential diagnosis and management of abnormal posture of the head and neck. J Korean Med Assoc 2009;52:705–718.
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    MeSH Terms
    Child
    Follow-Up Studies
    Humans
    Infant
    Neck
    Palpation
    Torticollis
    Metrics
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