Spot the Difference: Pediatric Metopic Craniosynostosis vs. Metopic Ridge
Chapter 1 of 4
Diagnostic challenge
Clinical scenario and diagnostic challenge
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
What the experts said
Metopic ridge is a normal variant with prevalence estimated at 10-20% of all births.
Mild ridging can be found on many patients if examined carefully.
Metopic craniosynostosis does not require presence of a palpable ridge.
Trigonocephaly is the triangular head shape seen in metopic craniosynostosis.
Benign metopic ridges usually fade due to muscle growth, scalp thickening, hair growth, and some bony remodeling.
Benign metopic ridges are rare to see after puberty.
The metopic suture is the earliest closing suture, typically closing between 3 to 9 months.
Virchow's law states that when a suture is fused, skull growth perpendicular to that suture will be arrested and growth will happen in the parallel direction.
Head shape is the key diagnostic feature, more important than palpable ridge, fontanelle size, or prominent suture.
If the presentation is subtle, it is probably not surgical.
When in doubt about metopic craniosynostosis versus ridge, refer to a specialist.
In metopic craniosynostosis, premature fusion of the metopic suture prevents the forehead from growing wider.