Perinatal clinical case

  • Marta Alves Pediatrics Department, Hospital Senhora da Oliveira – Guimarães
  • Liliana Branco Pediatrics Department, Hospital de Braga
  • Andreia Lopes Pediatrics Department, Hospital Senhora da Oliveira – Guimarães
  • Bárbara Pereira Pediatrics Department, Hospital Senhora da Oliveira – Guimarães
Keywords: Fibromatosis colli, Newborn, Torticollis

Abstract

A 16-day-old male was observed at the Emergency Department for a right cervical mass noticed on the same day by the parents, with no other associated symptoms. He was a fullterm child, delivered by vacuum extraction, with an uneventful perinatal period.
At the time of physical examination, a cervical mass was palpable in the inferior portion of the right sternocleidomastoid muscle, in association with ipsilateral torticollis.
Cervical ultrasound revealed a fusiform thickening of the sternocleidomastoid muscle, with well-defined, hypoechoic margins, confirming the diagnosis of fibromatosis colli.
Parents were instructed to adopt positioning measures and physical therapy was initiated, with clinical resolution by seven months of age.
Fibromatosis colli is the most severe presentation of congenital muscular torticollis. Although typical clinical findings usually enable the diagnosis, cervical ultrasound is useful to confirm muscular origin of the mass.
Torticollis in the opposite direction of the mass, spinal deformities, abnormal eye movements, or other abnormal neurological findings

References

Macias C, Gan V (2017). Congenital muscular torticollis: Clinical features and diagnosis. In Phillips W (Ed.), UpToDate. Retrieved February 2018 from: www.uptodate.com/contents/congenital-muscular-torticollis-clinical-features-and-diagnosis.

Cheng JC, Wong MW, Tang SP, et al. 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.

Kaplan SL, Coulter C, Fetters L. Physical therapy management of congenital muscular torticollis: an evidence-based clinical practice guideline: from the Section on Pediatrics of the American Physical Therapy Association. Pediatr Phys Ther. 2013; 25(4):348-94.

Published
2019-01-02
Section
What is your Diagnosis?