The Congenital Muscular Torticollis Severity Grading Scale is a tool used to assess the severity of torticollis in patients based on specific patient attributes and physical examination findings. This assessment involves collecting four key pieces of information:

- Age at examination: options include <= 6 months, 7-9 months, 10-12 months, and > 12 months.
- Presence of a sternocleidomastoid mass: options are Present or Absent.
- Postural preference: options are Yes or No.
- Difference in cervical rotation passive range of motion between the left and right sides: options include < 15 degrees, 15-30 degrees, and > 30 degrees.

The calculator uses a systematic approach to determine the severity grade by analyzing combinations of the input data. Let's outline the logic used to compute the different severity grades:

- Grade 1, early mild: The patient is <= 6 months old, the sternocleidomastoid mass is absent, and the rotation difference is < 15 degrees, regardless of postural preference.
- Grade 2, early moderate: The patient is <= 6 months old, the sternocleidomastoid mass is absent, and the rotation difference is between 15-30 degrees, regardless of postural preference.
- Grade 3, early severe: The patient is <= 6 months old and either has a present sternocleidomastoid mass or an absent mass with a rotation difference > 30 degrees, regardless of postural preference.
- Grade 4, later mild: The patient is 7-9 months old, the sternocleidomastoid mass is absent, and rotation difference is < 15 degrees, regardless of postural preference.
- Grade 5, later moderate: The patient is 10-12 months old, the sternocleidomastoid mass is absent, and the rotation difference is < 15 degrees, regardless of postural preference.
- Grade 6, later severe: For a patient aged 7-9 months, the sternocleidomastoid mass is absent with a rotation difference of 15-30 degrees or > 30 degrees, or if the patient is 10-12 months old, the mass is absent with a 15-30 degree difference, regardless of postural preference.
- Grade 7, later extreme: If the patient is aged 7-9 or 10-12 months and has a present mass, or if the patient is 10-12 months with an absent mass and a rotation difference > 30 degrees, regardless of postural preference.
- Grade 8, very late: The patient is > 12 months old, with either an absent mass and present postural preference, or a present mass, regardless of postural preference and rotation difference.

By evaluating these conditions, the calculator provides a severity grade, giving insight into the degree of torticollis and potentially guiding treatment and observation strategies.

The Congenital Muscular Torticollis Severity Grading Scale is a clinical calculator used in the pediatric population, specifically for infants and children diagnosed with congenital muscular torticollis (CMT). CMT is a condition in which an infant's neck muscle is shortened causing the neck to twist. This grading scale helps clinicians to quantify the severity of the condition and monitor the progress of the treatment. It takes into account factors such as the degree of head tilt, range of motion in the neck, and the presence of a palpable sternocleidomastoid mass. The clinical utility of this calculator is to guide treatment decisions, monitor the effectiveness of interventions, and provide a standardized measure for research purposes. There are no specific exclusion criteria for its use, but it is not applicable to patients without a diagnosis of CMT or to those with other types of neck abnormalities.

Congenital Muscular Torticollis Severity Grading Scale

Physical Therapy Management of Congenital Muscular Torticollis: A 2018 Evidence-Based Clinical Practice Guideline From the APTA Academy of Pediatric Physical Therapy.