January Week 4
CONGENITAL TORTICOLLIS: PIR.
After being scheduled 5 patients at the same time in CYAS clinic and seeing the 4th one, you see your next patient before noon conference who is a 3 week old boy here for evaluation of a right sided neck mass. It was discovered by the patients uncle who is a family medicine doctor. The baby born full term at 9 lb 5 ounces. Delivery involved forceps and APARS were 8/9. Exam shows a healthy baby boy that is well appearing with head tilted to the right. He resists rotation to the left. A hard 2X3 cm mass is palpated in the right sternocleidomastoid muscle. The mass is nontender and mobile. There are no other masses.
1. What is the most likely etiology?
2. What is a possible cause to this that would be apparent in the birth history?
3. If you wanted to evaluate this neck mass what imaging would you do?
4. What is the appropriate treatment? What can result from improper treatment?
5. What are some potential complications?
6. What are most cases of this acquired form of the disease caused by?
7. What are some other causes of this disease?