Ann Rehabil Med.  2011 Aug;35(4):485-490. 10.5535/arm.2011.35.4.485.

Screening for the Coexistence of Congenital Muscular Torticollis and Developmental Dysplasia of Hip

• Kim SN
• Shin YB
• Kim W
• Suh H
• Son HK
• Cha YS
• Chang JH
• Ko HY
• Lee IS
• Kim MJ

• KMID: 1971713
• DOI: http://doi.org/10.5535/arm.2011.35.4.485

Abstract

OBJECTIVE
To investigate the coexistence rate and related factors of developmental dysplasia of the hip (DDH) and congenital muscular torticollis (CMT), and to determine whether ultrasonography (US) gives good value for screening of DDH in CMT. METHOD: We prospectively examined 121 infants (73 males and 48 females) diagnosed with CMT to determine the incidence of DDH by US. We also assessed the relationship between neck US findings and DDH occurrence, and investigated the clinical features of CMT related to DDH.
RESULTS
18 patients (14.9%) were diagnosed as having DDH by US. However, most DDH was subclinical and spontaneously resolved. Only 2 patients (1.7%) needed to be treated with a harness. The positive predictive value of clinical examinations for DDH was 52.6% and patients treated by harness were all clinically positive. DDH was more common in the left side (13 left, 4 right, 1 both), but 6 out of 18 DDH (33.3%) cases presented on the contralateral side of CMT. Sex difference was not observed. Breech presentation and oligohydramnios were not related to DDH occurrence. Neck US findings did not correlate with DDH occurrence.
CONCLUSION
The coexistence rate of CMT and DDH was concluded to be 14.9%. If only DDH cases that required treatment were included, the coexistence rate of these two disorders would be lowered to 1.7%. All of these patients showed positive findings in clinical examination. Therefore, hip US should not be recommended routinely for patients with CMT.

Keyword

Congenital muscular torticollis; Developmental dysplasia of the hip; Ultrasonography

MeSH Terms

Breech Presentation
Female
Hip
Humans
Incidence
Infant
Male
Mass Screening
Neck
Oligohydramnios
Pregnancy
Prospective Studies
Sex Characteristics
Torticollis
Torticollis

Figure

• 

  Fig. 1 Ultrasonographic grading of congenital muscular torticollis. (A) Grade 1 was defined when the thickness of involved SCM muscle was increased compared to the normal side. (B) Grade 2 was defined when well-demarcated heteroechoic region was observed. (C) Grade 3 was defined when diffuse hyperechoic fibrous mass was observed.

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