Purpose or Case Report: Congenital muscular torticollis (CMT) is a common disorder of the musculoskeletal system in neonates and infants. Most CMT patients can be treated with stretching exercise but some patients with do not response to the treatment. Diffusion tensor imaging (DTI) is an emerging tool to measure and evaluate skeletal muscle injury. Our aim was to evaluate whether DTI has potential to show the difference in the affected muscle in CMT patients.
Methods & Materials: Six CMT patients (22.3 ± 30.8 months) for whom conservative management was not successful were selected by a clinician and were evaluated using DTI. Fractional anisotropy (FA) and mean diffusivity (MD) of the involved sternocleidomastoid (SCM) muscle were compared with that of the intact SCM muscle on the other side.
Results: The mean FA value of the involved SCM muscles was significantly higher than that of the intact SCM muscles (0.437 ± 0.051 vs. 0.364 ± 0.022, P = 0.009). The mean MD value of the involved SCM muscles was not significantly different to that of intact SCM muscles (0.155 ± 0.019 vs. 0.155 ± 0.018, P = .979).
Conclusions: DTI measures of FA values were significantly higher in the involved SCM muscles in patients with CMT. This may reflect the subtle change in the involved muscle which may progress in later stages and become fibrotic. Further studies correlating the DTI values with clinical outcome are needed.