The value of high-frequency and color Doppler ultrasonography in diagnosing congenital muscular torticollis

Lei Wang,Yuanjiao Tang,Lingyan Zhang,Li Qiu

doi:10.1186/1471-2474-13-209

Abstract

BackgroundCongenital muscular torticollis (CMT) is a relatively common neck deformity in infancy. The aim of our research was to determine the value of high-frequency and color Doppler ultrasonography in diagnosing CMT.MethodsPatients with a clinical suspicion of CMT underwent an ultrasound examination before diagnosis, and the sonographic characteristics were analyzed and compared with the clinical findings.ResultsThe sensitivity and specificity of an ultrasound diagnosis for CMT was 95.83% and 83.33%, respectively. The patients were divided into 2 groups based on the stage of the disease: the early-stage group (age <1 year) and the late-stage group(age ≥1 year). Differences existed between the two groups with respect to sonographic findings and clinical characteristics. The sonographic characteristics of the early-stage group included local thickening of the sternocleidomastoid muscle (SCM), weak or uneven echoes, and blood flow signals around or inside most of the lesions. The sonographic characteristics of the late-stage group included diffusely hyperechoic, or cord-like hyperechoic signals inside the muscle layer without significant blood flow signals.ConclusionsDifferent stage of CMT patients had different sonographic characteristics. High-frequency and color Doppler ultrasonography can serve as adjunct confirmation tool for the diagnosis of CMT.

Highlights

Congenital muscular torticollis (CMT) is a relatively common neck deformity in infancy
Study approval was waived by the Institutional Review Board (IRB) as this was considered a diagnostic procedure for patient benefit
Ultrasound diagnostic test of CMT Ninety-six of 108 patients were diagnosed with CMT, and 92 patients had an abnormal sternocleidomastoid muscle (SCM) on ultrasonographic examination; no SCM abnormalities were demonstrated in the other 4 patients

Summary

Introduction

Congenital muscular torticollis (CMT) is a relatively common neck deformity in infancy. Congenital muscular torticollis (CMT) is a relatively common neck deformity in infancy, with a reported incidence of 0.3% - 1.9% [1]. No deformity is apparent at birth, but a neck mass appears 7–10 days after birth, and resolves several months later, after changing into contractures and fibrosis of the SCM. This results in an inclination of the head toward the affected side. Facial and head deformities develop over time, which may seriously affect the patient’s work and quality of life [1]. The direct causes of SCM fibrosis are excessive deposition of extracellular matrix collagen and changes of other extracellular matrix components [2]

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