Dr. Vinod Dubey

  • Kandivali | Malad | Mira Bhayandar | Thane
  • +91 8108127022 / 6358854077 / 8369338859
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Torticollis, sprengel shoulder and other scapular deformity

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What is congenital muscular torticollis?

Congenital muscular torticollis is a condition in which an infant’s neck muscle is shortened causing the neck to twist. Congenital means present at birth and torticollis means twisted neck. The condition is sometimes called wryneck.

Causes

Congenital muscular torticollis may occur following a difficult birth, especially if the infant is delivered breech. During the delivery, if the sternocleidomastoid muscle, the neck muscle that extends from the jawbone (mastoid) to the clavicle (collarbone) and sternum (breastbone), is stretched or pulled, it may tear, causing bleeding and bruising within the muscle. The injured muscle develops fibrosis (scar tissue) which causes the muscle to shorten and tighten, pulling the infant’s head to one side. The fibrosis forms a mass or lump that sometimes can be felt on the side of the neck.

Symptoms

Congenital muscular torticollis may be visible at birth or it may not become evident until several weeks later. The following are the most common symptoms of congenital muscular torticollis. However, each child may experience symptoms differently. Symptoms may include:

  • Tilting of the infant’s head to one side
  • The infant’s chin turns toward the opposite side of the head
  • Firm, small, one to two centimeter mass in the middle of the sternocleidomastoid muscle

The symptoms of congenital muscular torticollis may resemble other neck masses or medical problems. Always consult your child’s doctor for a diagnosis.

Diagnosed

Generally, physical examination of the infant may show the characteristic tilting of the head and tension of the sternocleidomastoid muscle, as well as presence of a mass in the middle portion of the muscle. In addition to a complete medical history and physical examination, diagnostic procedures for congenital muscular torticollis may include the following:

  • X-rays. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film to check for abnormalities in the bones of the neck and shoulders.
  • Ultrasound examination. A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs to evaluate the muscle around the mass. Ultrasounds are used to view internal organs as they function and to assess blood flow through various vessels.

Treatment

If the condition is not corrected, the infant will be unable to move his or her head properly. Permanent muscle tightening with asymmetry (uneven development) of the neck and face can result. Specific treatment of congenital muscular torticollis will be determined by your child’s doctor based on:

  • Your child’s age, overall health, and medical history
  • Extent of the condition
  • Your child’s tolerance for specific medications, procedures or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

Treatment may include:

  • Gentle stretching exercise program (to help relieve the tension and lengthen the sternocleidomastoid muscle)
  • Infant stimulation (to help the infant learn to move and stretch the muscle)
  • Surgery (to correct the shortened muscle)

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FAQ'S

What is the basic knowledge of cardiology?

Cardiology is the medical specialty that deals with the diagnosis and treatment of diseases related to the heart and blood vessels. Basic knowledge of cardiology includes understanding the anatomy and function of the heart, the various cardiovascular diseases, risk factors for heart disease, diagnostic techniques such as electrocardiograms (ECGs) and echocardiograms, treatment options including medications, interventions, and surgeries, and preventive measures to maintain heart health.

What are some good questions to ask a cardiologist?
  • What lifestyle changes can I make to improve my heart health?
  • What are the risk factors for heart disease, and how can I manage them?
  • What symptoms should I be aware of that might indicate a heart problem?
  • What diagnostic tests might be necessary to assess my heart health?
  • What are the treatment options available for my specific condition?
  • Are there any potential side effects or risks associated with the prescribed medications?
  • How often should I have follow-up appointments to monitor my heart health?
  • Are there any specific dietary recommendations I should follow?
  • Can you provide information on cardiac rehabilitation programs?
  • What steps can I take to prevent future heart problems?
What Type of Cardiologist Should You See for Specialized Heart Care?
  1. The type of cardiologist you should see for specialized heart care depends on your specific condition. Here are a few examples:
  • Interventional Cardiologist: Specializes in performing procedures such as angioplasty, stenting, and catheter-based treatments for coronary artery disease and other structural heart problems.
  • Electrophysiologist: Focuses on the diagnosis and treatment of heart rhythm disorders (arrhythmias) using techniques like electrophysiology studies and cardiac ablation.
  • Heart Failure/Cardiomyopathy Specialist: Specializes in managing heart failure and cardiomyopathy, including the use of advanced therapies like implantable devices or heart transplantation.
  • Adult Congenital Heart Disease Specialist: Deals with the diagnosis and treatment of heart conditions that were present since birth but persist into adulthood.
  • Cardiovascular Surgeon: Performs surgical procedures on the heart and blood vessels, such as coronary artery bypass grafting, heart valve repair or replacement, and heart transplantation.
What are the different types of heart disease?
  1. Coronary artery disease (CAD): This is the most common type of heart disease and occurs when the coronary arteries, which supply blood to the heart, become narrow or blocked due to a buildup of plaque.
  2. Heart failure: This refers to a condition where the heart is unable to pump enough blood to meet the body’s needs. It can result from various underlying causes such as CAD, high blood pressure, or heart valve disease.
  3. Arrhythmias: These are abnormal heart rhythms that can occur due to electrical disturbances in the heart. They can cause the heart to beat too fast, too slow, or irregularly.
  4. Heart valve disease: This condition occurs when one or more of the heart valves do not function properly. It can involve valve stenosis (narrowing) or valve regurgitation (leakage).
  5. Cardiomyopathy: This refers to diseases of the heart muscle, where the muscle becomes thick, rigid, or weak, affecting the heart’s ability to pump effectively.
  6. Congenital heart disease: This is a type of heart disease that is present at birth. It involves structural defects in the heart that affect its normal function.
  7. Pericardial disease: This involves inflammation or abnormalities of the pericardium, the sac-like membrane surrounding the heart.
What are the common symptoms of heart disease?
  1. Chest pain or discomfort (angina): This is a common symptom of coronary artery disease. It may feel like pressure, tightness, or a squeezing sensation in the chest.
  2. Shortness of breath: Difficulty breathing or feeling breathless, especially with exertion or when lying flat, can be a sign of heart disease.
  3. Fatigue: Feeling excessively tired or lacking energy, even with minimal physical activity, may be a symptom of heart disease.
  4. Heart palpitations: Sensations of a rapid, fluttering, or pounding heartbeat may occur with certain heart conditions.
  5. Dizziness or fainting: Feeling lightheaded, dizzy, or actually fainting can be a result of inadequate blood flow to the brain due to heart problems.
  6. Swelling: Fluid retention can cause swelling in the legs, ankles, feet, or abdomen.
  7. Rapid weight gain: Sudden and unexplained weight gain may be a sign of fluid buildup related to heart failure.

It is important to note that these symptoms can also be caused by other conditions, and some individuals with heart disease may not experience any symptoms until a more advanced stage. If you are experiencing any concerning symptoms, it is recommended to consult a healthcare professional for a proper evaluation.