Disclosures: Eric M. Westerbeck, MD: Nothing to disclose

Case Description: The patient presented with chronic left-sided neck pain with an associated snapping sensation in that region with cervical rotation. This developed following an indoor rock-climbing fall 3 years previously. Cervical x-rays and magnetic resonance imaging were unrevealing. She trialed physical therapy, epidural steroid injections, chiropractic treatment, acupuncture, dry needling, cupping, prolotherapy and a cervical support pillow, all with limited success.

Setting: Outpatient Spine, Sport, and Joint Center

Patient: 30-year-old female with neck pain after a rock-climbing fall.

Assessment/Results: Her cervical range of motion, muscle size and neurologic examination were unremarkable. Ultrasound evaluation demonstrated a notable snapping of the sternocleidomastoid (SCM) over protuberant anterior tubercles of the C5 and C6 transverse processes with cervical rotation from right to left. This correlated with her localized discomfort. The left SCM was found to be significantly tight relative to the comparison on the right, felt to be likely related to the prior strain injury. There were no other structural abnormalities identified.

Discussion: There is little literature currently available describing a snapping SCM as a source of soft-tissue cervical pain. The dynamic capabilities of ultrasound provided a clear demonstration of this entity that was previously not identified with static imaging.

Conclusion: A snapping sternocleidomastoid should be within the differential of anterolateral soft-tissue cervical pain, particularly with symptom exacerbation with movement. Dynamic ultrasound can be used to potentially identify this condition.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/sternocleidomastoid-muscle-snapping-after-a-rock-climbing-fall-a-case-report/