title: Diagnostic features of prematurely fused cranial sutures on plain skull X-rays.
abstract: OBJECTIVE
  The characteristic features of prematurely fused craniosynostosis in plain radiographs have already been described in literature, but there is no clinical trial investigating the individual features of every single form of craniosynostosis. We described suture-specific characteristics as well as its frequency of appearance in plain radiographs in every different form of craniosynostosis. Intraoperative findings served as control to confirm the diagnosis.
  
  
  METHODS
  One hundred twenty-seven children with prematurely fused cranial sutures who underwent a skull X-ray from 2008 to 2012 were investigated in the present study. In detail, 34 children with frontal, 60 with sagittal, 13 with unilateral and 14 with bilateral coronal synostosis and 3 with unilateral lambdoid craniosynostosis as well as 3 children with a bilateral lambdoid synostosis were included.
  
  
  RESULTS
  Typical radiological characteristics in craniosynostosis exist. These features as well as its frequency in craniosynostosis in plain skull radiographs are presented. In all cases, these typical features enabled a correct diagnosis, which was confirmed by intraoperative findings.
  
  
  CONCLUSIONS
  The frequency of the appearance of typical features is listed and may serve as a "mental internal check list" in the radiological approach to craniosynostosis. The study points out the value of plain skull X-rays as it enabled proper diagnosis in all investigated 127 cases.
authors: Department of Neurosurgery, Section of Pediatric Neurosurgery, University Hospital of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany. schweitzer_t@ukw.de.
authors: Tilmann
authors: T
authors: Schweitzer
authors: Department of Orthodontics, University Hospital of Würzburg, Würzburg, Germany.
authors: Felix
authors: F
authors: Kunz
authors: Department of Orthodontics, University of Göttingen, Göttingen, Germany.
authors: Philipp
authors: P
authors: Meyer-Marcotty
authors: Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Würzburg, Würzburg, Germany.
authors: Urs Dietmar Achim
authors: UD
authors: Müller-Richter
authors: Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Würzburg, Würzburg, Germany.
authors: Hartmut
authors: H
authors: Böhm
authors: Department of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany.
authors: Clemens
authors: C
authors: Wirth
authors: Department of Neurosurgery, University Hospital of Würzburg, Würzburg, Germany.
authors: Ralf-Ingo
authors: RI
authors: Ernestus
authors: Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Würzburg, Würzburg, Germany.
authors: Christian
authors: C
authors: Linz
mesh_terms: D003393:Cranial Sutures / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D047928:Premature Birth / Q000473:pathology*; D011859:Radiography; D012189:Retrospective Studies; D013580:Synostosis / Q000000981:diagnostic imaging*; D014965:X-Rays
keywords: Cranial suture; Craniosynostosis; Diagnostic feature; Imaging; Plain skull X-ray