[Radiographic changes in non-operated isolated sagittal suture synostosis]

To characterize the spontaneous clinical course of isolated sagittal synostosis based on planar skull radiography.

In this retrospective analysis we evaluated a total of 155 radiographs of 55 children 2 weeks to 9 years old. The sagittal, coronal and lambdoid sutures were evaluated on the basis of pairs of ap and lateral radiographs. The sutures were examined with respect to their boundary, activity, and conspicuity to be visualized (based on a 3-grade score system). Six selected points on the skull X-ray defined eight measured distances, three angles, and a width-length index. To document changes over time, the measurements were correlated to normal values. In addition, a correlation between suture activity and selected parameters was evaluated.

The sagittal suture could be continuously or partially depicted in more then half of all radiographs taken during the first year of life, The measured distances and angles were concordant with results from the literature. With increasing age, the width-length index deviated from standard values while other parameters approximated the norm.

In the case of children younger than twelve months, the sagittal suture appears radiologically open in many cases despite clear-cut scaphocephaly. Definite signs of progressive plurisutural fusion were not found in this series. The dolichocephalic deformity remained unchanged while some signs of scaphocephalic appearance actually improved.