This will be a look and proceed case.
- Patient sitting - look from front and back
- “This patient has torticolis, will go on to elicit the cause of it”
- Comment on side of the tilt - chin is towards the right/ left
- Anterior - dysmorphic features, facial asymmetry
- Posterior for KFS features - low hair line, short webbed neck, stiff ROM
- Check mouth for pharyngitis
- check eyes - do H movement - “there is no ocular squint”
- Auditory - i do not see any hearing aids that suggest auricular cause
- Move
- Patient has restricted ROM due to this deformity
- Ask “Is there any pain” - this will open up pain vs painless torticollis - likely no pain
- feel
- Palpate SCM (fibrous nodule) - mention that the SCM is tight on the right with chin pointing to the left, supporting diagnosis of a CMT and not AARD which is opposite
- Cervical spine - confirm no tenderness (AARD)
- Look for associated features with CMT
- Packaging disorders set - Plagiocephaly, tibial PM bowing, tibia internal torsion, metatarsus adductus,
- Complete my exam with full neurological exam