Congenital Muscular Torticollis vs. Klippel-Feil Syndrome
Left picture: Due to the typical local finding in the view from the front, the diagnosis is a congenital muscular torticollis. Right picture: An x-ray of the shoulder confirms the diagnosis of a Sprengelīs deformity; this anomaly is often combined with a Klippel-Feil syndrome (disease) which is an important differential diagnosis of a congenital muscular torticollis, and which can be diagnosed only by x-ray. The radiological imaging in these cases exhibits typical vertebral anomalies of the cervical spine.
In both toddlers a somewhat higher scapula is recognizable on the right side which stands apart from the chest wall. The general clinical examination also shows that the head is somewhat inclined to the right side in both cases and rotated more distinctly to the left side in the girl and less in the boy; therefore, the left auricle is better visible in both.