Smith's Recognizable Patterns of Human Deformation

Lambdoidal Craniosynostosis

KEY POINTS Lambdoidal craniosynostosis is often an isolated anomaly but can be associated with muscular torticollis or an abnormal fetal lie/birth presentation. Differential diagnosis includes nonsynostotic deformational posterior plagiocephaly, synostotic anterior plagiocephaly, and other forms of craniosynostosis. Unilateral lambdoidal craniosynostosis…

Metopic Craniosynostosis

KEY POINTS The metopic suture is the first cranial suture to close and normally closes by 8 to 9 months. Mild degrees of metopic ridging occur frequently at birth, but unless there is progressive distortion of the orbits, it usually…

Coronal Craniosynostosis

KEY POINTS Coronal craniosynostosis may occur as an isolated finding or as part of several genetic disorders. Coronal craniosynostosis can be unilateral or bilateral and can be caused by early descent of the fetal head into a constraining position, or…

Sagittal Craniosynostosis

KEY POINTS Sagittal craniosynostosis limits lateral cranial expansion, with progressive frontal and/or occipital prominence and ridging along the mid-posterior portion of the skull. Sagittal synostosis can result from fetal head constraint secondary to factors such as twining, oligohydramnios, or early…

Craniosynostosis: General

KEY POINTS Differentiating between craniosynostosis and primary cranial deformation is critical to determining the proper mode of treatment. It is important for pediatric and primary care providers to know the normal range and timing of fontanel and cranial suture closure.…

Positional Brachycephaly

KEY POINTS Brachycephaly is defined as a shortened, wide head, often caused by constant supine positioning during infancy. Infants should be placed on their backs for sleep but on their stomachs during awake time under adult supervision to encourage neck…

Plagiocephaly

KEY POINTS Deformational plagiocephaly is most common in first born, large babies, breech presentation, and multiple-gestation infants. Factors associated with asymmetric head deformation include a constraining intrauterine environment, clavicular fracture, cervical/vertebral abnormalities, and incomplete bone mineralization. Nonsynostotic , deformational ,…

Congenital Muscular Torticollis

KEY POINTS Congenital muscular torticollis (CMT) must be distinguished from acquired torticollis and underlying structural torticollis (from cervical vertebral anomalies). It is most often caused by a congenital asymmetry in the length and/or strength of the sternocleidomastoid (SCM) muscles. CMT…