Practical Examination of Torticollis

Examination from

Examination starts after consent and order from the examiner.

Expoure requires upto umbilicus .


Front

  bent on lt side ,
 
  chin deviated to  rt side

 decreased head shoulder distance on lt side

 oral cavity looks normal /abnormal

 no squinting

 facial asymmetry - normal ?

 lt side sternocleidomastoid - taut


chest - no muscle wasting

Side

   Ear almost touching shoulder  ,
 
   Deltoid contour normal

    elbow fully extended


Back

     b/l shoulder symmetrical , hairline

     scapula at same level

     occiput flat

     Thoracic and lumbar curvature maintained with no scoliosis


Gait and Squating - normal

 Feel - lt sternocleidomastoid taut , thick

           no tenderness on mastoid, sternum , clavice, AC joint , scapula , humerus and C-spine

          No palpable lymph nodes, no tenderness on supra / infraspinatus fossa

       
Movement

          Flexion / Extension , Rotation , Lateral Flexion both active and passive

          meaure the angle head is bent.

Vascular Examination

Neurologic examination of upper extremities  / lowe extremities

 dermatome / myotomes

 sensation

 Reflexes

Discussion on Klepel - Feil Syndrome , Sprengel's deformity , Causes of Torticollis and its treatmenT. It will be added in future posts.