Metopic suture
Last revised by Tariq Walizai
on 5 Dec 2024
Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Walizai T, Ashraf A, et al. Metopic suture. Reference article, Radiopaedia.org (Accessed on 20 Mar 2025) https://doi.org/10.53347/rID-19799
rID:
19799
Article created:
Disclosures:
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosures
Last revised:
5 Dec 2024,
Tariq Walizai
Disclosures:
At the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.
View Tariq Walizai's current disclosures
Revisions:
21 times, by
17 contributors -
see full revision history and disclosures
Systems:
Sections:
Synonyms:
- Persistent metopic suture
- Frontal suture
- Median frontal suture
- Interfrontal suture
The metopic suture (also known as the frontal, interfrontal, or median frontal suture) is a vertical fibrous joint that divides the two halves of the frontal bone and is present in a newborn.
Persistent metopic sutures can be misdiagnosed as vertical skull fractures, therefore it is important to be aware of this anatomical variant.
On this page:
Gross anatomy
This suture runs through the midline across the frontal bone from the nasion to the bregma, although it may often be incomplete. It may fuse as early as 3 months of age and should fuse in nearly all patients by around 9 months of age 1-4.
Premature fusion of the suture is termed metopic synostosis (type of craniosynostosis) which can then result in trigonocephaly.
Variant anatomy
The metopic suture is usually obliterated by about 7 years of age, but in rare cases, it can persist 6 as an anatomical variant of little clinical significance but that it can be mistaken for a frontal bone fracture. Persistence of the metopic suture may be associated with frontal sinus agenesis or hypoplasia 7.
Differential diagnosis
-
metopic sutures have a characteristic midline position and demonstrate sutural interdigitations 4
References
- 1. Vu HL, Panchal J, Parker EE et-al. The timing of physiologic closure of the metopic suture: a review of 159 patients using reconstructed 3D CT scans of the craniofacial region. J Craniofac Surg. 2001;12 (6): 527-32. J Craniofac Surg (link) - Pubmed citation
- 2. Weinzweig J, Kirschner RE, Farley A et-al. Metopic synostosis: Defining the temporal sequence of normal suture fusion and differentiating it from synostosis on the basis of computed tomography images. Plast. Reconstr. Surg. 2003;112 (5): 1211-8. doi:10.1097/01.PRS.0000080729.28749.A3 - Pubmed citation
- 3. Murlimanju BV, Prabhu LV, Pai MM et-al. Median frontal sutures - incidence, morphology and their surgical, radiological importance. Turk Neurosurg. 2011;21 (4): 489-93. doi:10.5137/1019-5149.JTN .4293-11.0 - Pubmed citation
- 4. Glass RB, Fernbach SK, Norton KI et-al. The infant skull: a vault of information. Radiographics. 2004;24 (2): 507-22. Radiographics (full text) - doi:10.1148/rg.242035105 - Pubmed citation
- 5. Bademci G, Kendi T, Agalar F. Persistent metopic suture can mimic the skull fractures in the emergency setting?. Neurocirugia (Astur). 2007;18 (3): 238-40. Pubmed citation
- 6. FRCS CSS. Last's anatomy. Churchill Livingstone. ISBN:0443100330. Read it at Google Books - Find it at Amazon
- 7. Çakur B, Sumbullu MA, Durna NB. Aplasia and agenesis of the frontal sinus in Turkish individuals: a retrospective study using dental volumetric tomography. Int J Med Sci. 2011;8 (3): 278-82. Free text at pubmed - Pubmed citation
Incoming Links
Articles:
Cases:
- Trigonocephaly
- Persistent metopic suture with frontal sinus agensis
- Persistent metopic suture
- Persistent metopic suture
- Trigonocephaly
- Trigonocephaly
- Persistent metopic suture
- Metopic ridge
- Persistent metopic suture
- Trigonocephaly
- Trigonocephaly
- Sotos syndrome
- Persistent metopic suture
- Persistent metopic suture
- Persistent metopic suture
- Metopic suture synostosis
- Trigonocephaly
- Trigonocephaly
- Brachycephaly (bicoronal synostosis)
- Persistent metopic suture
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