Initial Imaging for Brachycephaly and Metopic Ridge

Clinical Examination and Imaging Recommendations

• Clinical examination by experienced craniofacial specialists is usually sufficient to diagnose plagiocephaly and metopic ridge abnormalities without the need for imaging 1
• Three-dimensional topographical scanning may be useful for baseline assessment of severity but is not required for diagnosis 1
• Skull X-rays or ultrasound of the suspect suture is almost always sufficient for definitive diagnosis, providing adequate visualization while minimizing radiation exposure 1, 2
• Ultrasound can effectively assess suture patency in infants 1
• CT scan without contrast should be used sparingly and only when necessary to rule out true craniosynostosis, as it carries radiation risks 1, 2
• The benefit of diagnosis using CT scan must outweigh the radiation exposure risk 1
• MRI has no role in the diagnosis of brachycephaly or metopic ridge abnormalities 1, 2
• Routine CT scanning should be avoided due to radiation exposure concerns 3