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Pseudotumor of infancy and congenital muscular torticollis
1Weed Army Hospital, Ft. Irwin, California, USA.
Insights
Pseudotumor of infancy is a sternocleidomastoid muscle mass in newborns. Early treatment of this condition and resulting congenital muscular torticollis with physical therapy is effective for most infants.
Area of Science:
- Pediatric Orthopedics
- Neonatal Musculoskeletal Conditions
Background:
- Pseudotumor of infancy is a firm mass in the sternocleidomastoid muscle of newborns.
- It can lead to congenital muscular torticollis in 10-20% of cases, potentially causing craniofacial asymmetry and scoliosis if untreated.
Purpose of the Study:
- To describe the presentation, diagnosis, and management of pseudotumor of infancy and associated congenital muscular torticollis.
- To highlight the importance of early intervention and conservative treatment approaches.
Main Methods:
- Review of clinical presentation and diagnostic modalities for pseudotumor of infancy.
- Discussion of treatment strategies for pseudotumor and congenital muscular torticollis, including conservative and surgical options.
Main Results:
- Congenital muscular torticollis and hip dysplasia are associated conditions.
- Diagnostic tools include imaging (ultrasound, CT, MRI) and biopsy.
- Conservative treatment (heat, massage, stretching) is effective in over 70% of cases.
Conclusions:
- Pseudotumor of infancy requires differentiation from other cervical masses.
- Conservative management is the primary approach for pseudotumor and congenital muscular torticollis.
- Surgery is reserved for persistent cases beyond the first year of life.
Abstract:
Pseudotumor of infancy presents as a discrete, firm mass in the distal sternocleidomastoid muscle in infants two to four weeks of age. Congenital muscular torticollis may develop from the resultant fibrosis in 10 to 20 percent of cases. Hip dysplasia is an associated feature of congenital muscular torticollis in approximately 10 percent of cases. Pseudotumor of infancy must be differentiated from other causes of cervical soft tissue masses. Diagnostic choices include fine-needle aspiration biopsy, cervical radiography, ultrasonography, computed tomographic scanning of the head and neck, and magnetic resonance imaging. Left untreated, congenital muscular torticollis may lead to significant craniofacial asymmetry and scoliosis. Heat, massage and passive stretching exercises are the preferred initial treatments for pseudotumor and torticollis. More than 70 percent of patients will respond to this approach. Surgery should be reserved for treatment of cases that persist past the first year of life.