Skull Fracture or Accessory Sutures: How Do We Tell the Difference?

Dr. N. L. N. Moorthy, Dr. Pravallika Isireddy, Dr. B. N. Sandeep Reddy

Abstract: This article examines the challenges associated with differentiating between skull fractures and accessory sutures in paediatric radiology using plain film radiography. Skull fractures are often obscured by the presence of synchondroses and unusual accessory sutures in children. The study emphasizes the importance of three - dimensional reconstructions from cranial CT scans in confidently distinguishing questionable fractures from accessory sutures. Key characteristics such as bilaterality, symmetry, associated diastasis, and the presence of soft tissue swelling are discussed for accurate differentiation. Additionally, knowledge of normal anatomy and sutural closure timing is crucial in deciphering complex accessory sutures, particularly in the occipital region. In cases where differentiation remains elusive, follow - up studies can provide insights into the healing process, aiding in a definitive diagnosis.

Keywords: skull fractures, accessory sutures, paediatric radiology, cranial CT, radiographic differentiation