Pseudotumor of infancy and congenital muscular torticollis: 170 cases

Area of Science:

• Pediatric Orthopedics
• Developmental Pediatrics
• Physical Medicine and Rehabilitation

Background:

• Pseudotumor of infancy (POI) and congenital muscular torticollis (CMT) are common conditions affecting infants.
• These conditions can lead to plagiocephaly, facial asymmetry, and feeding difficulties.
• Early diagnosis and appropriate management are crucial for optimal outcomes.

Purpose of the Study:

• To review the clinical presentation and treatment outcomes of infants diagnosed with POI or CMT.
• To propose a treatment algorithm for managing these pediatric neck conditions.
• To assess the long-term resolution rates following various treatment modalities.

Main Methods:

• Retrospective review of 170 patients (81 boys, 89 girls) diagnosed with POI or CMT before 24 months of age.
• Data collected from 1962 to 1998 at a tertiary care center.
• Analysis included physical examination findings, imaging studies (radiography, CT, ultrasonography), and treatment outcomes.

Main Results:

• The mean age at diagnosis was 4 months, with over 90% presenting with head tilt.
• Plagiocephaly was noted in 39.5% of POI and 63.6% of CMT patients; neck masses in 63.2% of POI and 18.2% of CMT patients.
• Initial conservative treatment (passive range of motion) was recommended for 65.3%; 16 patients required surgery. Overall, 85.5% achieved total symptom resolution.

Conclusions:

• Children with POI or CMT require at least 12 months of observation and treatment.
• Surgical treatment should be considered for persistent symptoms after one year of conservative therapy.
• The majority of children with POI or CMT experience complete symptom resolution.