Which feature best differentiates craniosynostosis from positional plagiocephaly?

Which feature best differentiates craniosynostosis from positional plagiocephaly?

• A. Flattening along sutures
• B. Bossing along cranial sutures
• C. Symptom along sutures present
• D. No deformity

Answer: (B)

Distinguishing craniosynostosis from positional plagiocephaly hinges on whether the cranial sutures are fused. Premature fusion of a suture causes the skull to grow in directions away from the fused line, producing a noticeable ridge or bossing along the affected suture as the compensatory growth occurs elsewhere. That suture-based bossing is the clearest sign that a suture has closed early, pointing to craniosynostosis. In positional plagiocephaly, the sutures remain open and skull growth is simply redirected by external pressure; the deformity is typically a flattening in one region without a ridge along a suture. Imaging would show open sutures in plagiocephaly but fused sutures in craniosynostosis. So the best differentiating feature is bossing along the cranial sutures, reflecting premature suture fusion. Flattening along sutures or vague “symptoms along sutures” are not as specific, and no deformity is incorrect.

Distinguishing craniosynostosis from positional plagiocephaly hinges on whether the cranial sutures are fused. Premature fusion of a suture causes the skull to grow in directions away from the fused line, producing a noticeable ridge or bossing along the affected suture as the compensatory growth occurs elsewhere. That suture-based bossing is the clearest sign that a suture has closed early, pointing to craniosynostosis.

In positional plagiocephaly, the sutures remain open and skull growth is simply redirected by external pressure; the deformity is typically a flattening in one region without a ridge along a suture. Imaging would show open sutures in plagiocephaly but fused sutures in craniosynostosis.

So the best differentiating feature is bossing along the cranial sutures, reflecting premature suture fusion. Flattening along sutures or vague “symptoms along sutures” are not as specific, and no deformity is incorrect.