Torticollis | Testing and Diagnosis

How is torticollis diagnosed?

Here at Boston Children’s, our specialists will obtain a full medical history and perform a comprehensive physical exam of your child. When an infant is believed to have torticollis along with an underlying skeletal abnormality, x-ray imaging or magnetic resonance imaging (MRI) may be necessary to confirm the diagnosis. 

Medical history

Your child’s doctor will begin by asking you a series of questions that will help determine the type of torticollis your child has. Questions may include: 

  • How old is your child?
  • When did the torticollis develop?
  • Did the torticollis happen suddenly or slowly?
  • Was there any trauma to the head or neck?
  • Does your child have a fever?
  • Does your child have an infection?
  • Has your child had any surgeries in the head and/or neck?
  • Have you noticed any other symptoms?
  • Has your child been exposed to any medications or drugs? 

Physical examination

Your child’s doctor will perform a complete physical and neurological exam to determine the type of torticollis she has. This exam involves: 

  • checking the range of motion of the head and neck
  • palpating (examining by touch) the SCM muscle in the neck to see if there is a small lump, or “pseudo tumor,” that happens in about one in three cases of congenital muscular torticollis
  • looking for the presence or absence of asymmetry or unevenness of the face and head to check for a condition called plagiocephaly (it’s important to check for this because the child’s head and face may develop unevenly due to the pull of gravity upon the tilted head)
  • checking your baby’s hips and how they rotate (this is because there is a slightly higher chance that babies with congenital muscular torticollis may develop hip dysplasia

Your doctor may also request other imaging studies, such as ultrasound, to look for certain abnormalities in the spine that may be a sign of rare but serious health problems.