Sonographic Evaluation of Congenital Muscular Torticollis: A Case Study in Morphologic Asymmetry and Fibromatosis Colli
Faculty Mentor
Dr. Myka Bussey-Campbell
Location
Savannah Ballroom
Type of Research
Proposed
Session Format
Poster Presentation
College
Waters College of Health Professions
Department
Clinical Sciences
Abstract
Congenital Muscular Torticollis (CMT) is a prevalent pediatric musculoskeletal condition characterized by the shortening and fibrosis of the sternocleidomastoid (SCM) muscle, often presenting clinically as a palpable neck mass and restricted cervical range of motion. While the physical presentation can be alarming to caregivers, distinguishing the benign "pseudotumor" of infancy (Fibromatosis Colli) from malignant differentials such as rhabdomyosarcoma or neuroblastoma is critical. This case study evaluates the diagnostic utility of high-frequency sonography in characterizing the morphologic asymmetry associated with CMT.
A 4-week-old female infant presented with a palpable, firm, non-tender mass on the right lateral neck and a persistent rotational preference of the head to the left. A targeted sonographic interrogation was performed utilizing a 12-5 MHz linear array transducer. The protocol included longitudinal and transverse planes with side-by-side comparison of the bilateral SCM muscles. Color Doppler imaging was employed to assess internal vascularity.
Sonographic imaging revealed a focal, fusiform enlargement involving the lower two-thirds of the right SCM, measuring 1.8 cm in anterior-posterior diameter, compared to 0.6 cm in the contralateral normal SCM. The mass demonstrated a heterogeneous, hyperechoic texture consistent with fibrous replacement of normal muscle fibers. The mass moved synchronously with the SCM, confirming an intramuscular location. Color Doppler demonstrated internal flow within normal limits, ruling out hypervascular malignancy. No lymphadenopathy was visualized.
The sonographic features were pathognomonic for Fibromatosis Colli, confirming the diagnosis of Congenital Muscular Torticollis. This allowed for the immediate initiation of conservative management via physical therapy and the avoidance of ionizing radiation (CT) or sedation (MRI). This case underscores the role of sonography as the gold-standard modality for the rapid, non-invasive assessment of pediatric neck masses, specifically in quantifying morphologic asymmetry to monitor therapeutic regression.
Keywords: Congenital Muscular Torticollis, Fibromatosis Colli, Sternocleidomastoid, Pediatric Sonography, High-Frequency Ultrasound.
Program Description
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Start Date
4-21-2026 1:30 PM
End Date
4-21-2026 3:30 PM
Recommended Citation
Mooney, Lydia, "Sonographic Evaluation of Congenital Muscular Torticollis: A Case Study in Morphologic Asymmetry and Fibromatosis Colli" (2026). GS4 Student Scholars Symposium. 72.
https://digitalcommons.georgiasouthern.edu/research_symposium/2026A/2026A/72
Sonographic Evaluation of Congenital Muscular Torticollis: A Case Study in Morphologic Asymmetry and Fibromatosis Colli
Savannah Ballroom
Congenital Muscular Torticollis (CMT) is a prevalent pediatric musculoskeletal condition characterized by the shortening and fibrosis of the sternocleidomastoid (SCM) muscle, often presenting clinically as a palpable neck mass and restricted cervical range of motion. While the physical presentation can be alarming to caregivers, distinguishing the benign "pseudotumor" of infancy (Fibromatosis Colli) from malignant differentials such as rhabdomyosarcoma or neuroblastoma is critical. This case study evaluates the diagnostic utility of high-frequency sonography in characterizing the morphologic asymmetry associated with CMT.
A 4-week-old female infant presented with a palpable, firm, non-tender mass on the right lateral neck and a persistent rotational preference of the head to the left. A targeted sonographic interrogation was performed utilizing a 12-5 MHz linear array transducer. The protocol included longitudinal and transverse planes with side-by-side comparison of the bilateral SCM muscles. Color Doppler imaging was employed to assess internal vascularity.
Sonographic imaging revealed a focal, fusiform enlargement involving the lower two-thirds of the right SCM, measuring 1.8 cm in anterior-posterior diameter, compared to 0.6 cm in the contralateral normal SCM. The mass demonstrated a heterogeneous, hyperechoic texture consistent with fibrous replacement of normal muscle fibers. The mass moved synchronously with the SCM, confirming an intramuscular location. Color Doppler demonstrated internal flow within normal limits, ruling out hypervascular malignancy. No lymphadenopathy was visualized.
The sonographic features were pathognomonic for Fibromatosis Colli, confirming the diagnosis of Congenital Muscular Torticollis. This allowed for the immediate initiation of conservative management via physical therapy and the avoidance of ionizing radiation (CT) or sedation (MRI). This case underscores the role of sonography as the gold-standard modality for the rapid, non-invasive assessment of pediatric neck masses, specifically in quantifying morphologic asymmetry to monitor therapeutic regression.
Keywords: Congenital Muscular Torticollis, Fibromatosis Colli, Sternocleidomastoid, Pediatric Sonography, High-Frequency Ultrasound.
