Congenital Muscular Torticollis vs. Postural Torticollis
Left picture: In this girl the diagnosis is a congenital muscular torticollis of the left side. On looking closely the left sternocleidomastoid muscle is prominent. Right picture: The infant has a postural torticollis of the right side due to a right-left asymmetry of the muscle tonus. Nevertheless, the differentiation between a congenital muscular torticollis and a postural torticollis is sometimes only possible with accuracy on follow-up because the postural torticollis is often spontaneously reversible, which is never the case in a congenital muscular torticollis, concerning the local finding on palaption.
Both patients exhibit a recognizable torticollis, and on looking closely an asymmetry of the face. This asymmetry is visible only in the infant. Left picture: The girl has a fibrosis of the left muscle on comparative palpation of both sternocleidomastoid muscles. Right picture: In the infant the sternocleidomastoid muscle of the right side is hypertonic in comparison to the left muscle.