Other Cervical Spine Disorders
Chin is twisted upwards & towards one side
may be Congenital or Acquired
Congenital
- Congenital Muscular Torticollis (see below)
- Klippel -Feil syndrome
Acquired
may be Osseous or Non-osseous
- Osseus,
- Trauma - Atlantoaxial
- Infections
- tuberculosis
- pyogenic infections
- Grisel's syndrome - follows upper respiratory tract infection
- Tumours
- Osteoid osteoma
- Inflammatory
- ankylosing spondylitis
- Rheumatoid arthritis
- Non-osseus
- neck burn contractures
- ocular - with a superior oblique muscle paresis creating a compensatory head tilt
- Prolapsed disc
- Tumours
- intraspinal
- intracranial - posterior fossa (medulloblastomas, cerebellar astrocytomas, ependymomas)
- the sternomastoid on one side is fibrous & fails to elongate with growth -> progressive deformity
- associated with breech & DDH
- may be due to ischaemia of the muscle from a distorted position in-utero
- Clinical
- lump may be noticed in first few weeks of life
- deformity appears at age 1-2 years
- sternomastoid feels tight & hard
- asymmetrical facial development
- Treatment
- division of muscle - usually at lower end, but may require division at upper end as well; immobilise with a collar, then stretching exercises
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