Week 7 - Congenital Muscular Torticollis and Cranial Deformation

A comprehensive set of 100 vocabulary flashcards to aid in studying key concepts and terminology related to Congenital Muscular Torticollis and Cranial Deformation.

Congenital Muscular Torticollis (CMT)

A postural asymmetry caused by unilateral shortening or fibrosis of the sternocleidomastoid (SCM) muscle.

postural torticollis (POST)

Mild torticollis characterized by positional preference of the head and neck by the infant without limitations to PROM and without a nodule in the muscle

muscular torticollis (MT)

Moderate torticollis characterized by unilateral tightness of the SCM apparent during cervical rotation and/or lateral flexion, without a nodule in the muscle

SMC nodule

Severe torticollis characterized by palpable fibroid mass or tumor present in SCM with PROM limitations in either or both cervical rotation and lateral flexion

intrauterine malposition or birth trauma leading to SCM injury

Primary cause of CMT

vascular occlusion → localized ischemia/anoxia → fibrosis of the SCM

Proposed mechanism of CMT

cranial deformation (CD)

Non-congenital, secondary condition caused by sustained head position

4-6

Cranial remolding orthosis may be considered if CD remained moderate-severe after _____ months.

craniofacial asymmetries

Secondary condition characterized by a smaller, elevated eye affected side; mild posterior/inferior ear displacement; reduced jaw height or malocclusion

gross motor delay

Secondary condition related to asymmetrical posture; monitor developmental milestones

90%

Percentage of infants with CMT that show craniofacial asymmetry

True

T/F: CD can cause or result from CMT.

repositioning and prone play

First line intervention for CD/CMT dual diagnosis

6

Orthosis may be necessary if CD/CMT dual diagnosis persists beyond _____ months.

abnormal tone and poor visual tracking

Examples of findings inconsistent with CMT

standardized motor assessment

Priority activity for CMT examination

arthrodial protractor

Device commonly used to measure passive cervical rotation (inter-rater reliability ~ICC.71)

goniometer

Device used to measure cervical rotation in CMT; reliable for same-rater measures (ICC .87-.97)

Barlow Test

Screening test for DDH in which unstable hip is dislocated with posterior pressure

Ortolani Test

Screening test for DDH that reduces a dislocated hip with anterior lift

Galeazzi Sign

Uneven knee height indicating possible hip dislocation or leg length discrepancy

Craniosynostosis

Premature closure of one or more cranial sutures; requires urgent referral for evaluation

Functional Symmetry Observation Scale

A tool used to assess use of both sides of the body during movement.

Developmental Dysplasia of the Hip (DDH)

A condition that can co-occur with CMT; requires specific screening.

Craniofacial Asymmetries

Irregularities in skull shape and structure often resulting from conditions like CMT.

Ocular Muscle Imbalance

A condition that can impact tracking and coordination related to CMT.

FLACC Pain Scale

A tool used to assess distress and pain in infants during evaluation.

Muscle Function Scale (MFS)

A method for evaluating the strength of infants’ head righting.

TIMP

Standardized test for infants aged 0-4 months; predicts later motor performance at 3 months

AIMS

Standardized test for infants aged 4-18 months; predicts gross motor outcomes by 8 months

PDMS-2 (Gross Motor)

Standardized test for children up to 71 months; reliable for children with motor delays

prone and side-lying

Infants spending more time in _____ positions reach milestones sooner.

2; 10

Delay may appear by _____ months; most resolve by _____ months with PT.

10%

Percentage of children who show persistent delay or asymmetry.

shoulder

Part of the body that should be stabilized to prevent trunk compensation during passive stretching

1x/week or every other week

Recommended frequency of PT for mild CMT (<3 mo. Grade 1)

1-3x/week

Recommended frequency of PT for moderate-severe CMT (>3 mo or higher grade)

5-6 months

The skull remains malleable until what age?

surgical correction

Intervention required for most cases of craniosynostosis

lambdoid craniosynostosis

Type of craniosynostosis that is most often confused with plagiocephaly

6-8 weeks

Number of weeks of repositioning therapy recommended by the AAP before considering orthotic treatment

1mm/week

Rate of improvement with cranial orthoses at 5 months of age

head width / head length x 100

How is the CI calculated?

transcranial diagonal

Ratio of the longer to the shorter oblique cranial diameters, taken from 30/40 degrees either side of midline

diagnosis of deformational plagiocephaly

What does OCLR > 106 indicate?