Outpatient Specialty Care and Primary Care Clinical Pathway
for Congenital Muscular Torticollis
Primary Care Team Assessment
- History and Physical Exam
- Physical Exam Features of CMT
- Restricted cervical range of motion (ROM)
- Preference for cervical rotation to one side
- Head tilt to one side
- Mass or thickening of sternocleidomastoid muscle (SCM)
- Plagiocephaly Present
- Abnormal Findings
Unclear if CMT Present
CMT Present
- Monitor cervical ROM
- Provide Patient Education
- Re-evaluate head and neck ~ 1 mo
- Specialist Referral
- Imaging Recommendations
- PT Consult
- Provide Patient Education
- Imaging Recommendations
Routine PCP visits with cervical ROM reassessment and head shape monitoring
Posted: June 2023
Editors: Clinical Pathways Team
Editors: Clinical Pathways Team
Evidence
- Physical Therapy Management of Congenital Muscular Torticollis: A 2018 Evidence-based Clinical Practice Guideline From the APTA Academy of Pediatric Physical Therapy
- Congenital Muscular Torticollis: Bridging the Gap Between Research and Clinical Practice
- Neurodevelopmental Outcomes and Comorbidities of Children with Congenital Muscular Torticollis: Evaluation Using the National Health Screening Program for Infants and Children Database
- ACR Appropriateness Criteria Developmental Dysplasia of the Hip-Child
- Additional Evidence
CHOP Programs
- Congenital Muscular Torticollis
- Deformational Plagiocephaly
- Center for Rehabilitation
- Physical Therapy
- Division of Neurology
- Division of Orthopaedics
- Division of Plastic, Reconstructive and Oral Surgery
Media
- CHOP Rehab Roundtable Podcasts
- Primary Care Perspectives: Podcast for Pediatricians
Episode 152 - Torticollis: 3 Types and Takeaways