Wormian bones

Findings

There are numerous wormian bones (Figure 1, Figure 2, Figure 3, Figure 4, Figure 5, and Figure 6).
Wormian bones are within the sagittal suture (Figure 4) and the lambdoid sutures (Figure 5).
There is a metopic suture, which is an accessory frontal bone suture (Figure 4).


Diagnosis: Wormian bones


Wormian bones are secondary ossification centers within sutural lines. These characteristic locations should allow differentiation from fractures.
They occur most frequently in the lambdoid suture. They may present in normal infants up to the age of one year, and may be single or multiple. Associated pathologic entities include osteogenesis imperfecta, cleidocranial dysplasia, and hypothyroidism.
Other associations include pyknodysostosis, Down syndrome, progeria, hypophosphatasia, pachydermoperiostosis, otopalatodigital syndrome and Menke’s kinky hair syndrome.
This patient had normal variant Wormian bones without an associated diagnosis.