Cited by 499Craniofacial Disorders and TreatmentsGenomics and Rare DiseasesPectus Deformity Diagnosis and Treatment

The DOI matches its Crossref record; 54 of the 54 references it cites were found in a registry or an index; 29 of the 68 sources its claims cite were checked for support.

Craniosynostosis

Open access
Johnson, David, Wilkie, Andrew O M·2011·European Journal of Human Genetics

Abstract

Craniosynostosis, defined as the premature fusion of the cranial sutures, presents many challenges in classification and treatment. At least 20% of cases are caused by specific single gene mutations or chromosome abnormalities. This article maps out approaches to clinical assessment of a child presenting with an unusual head shape, and illustrates how genetic analysis can contribute to diagnosis and management.

Overview

Integrity signals

Registry

Crossref · 10.1038/ejhg.2010.235

Cites

54 of 54 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

29 of 68 cited sources checked · 17 supported · 1 flagged · accuracy not yet measured

  • It may state two separate claims as one. 27
  • Probably not a substantial claim. 5
31 of 31
  • The paper relies on this without support.

    Craniosynostosis can be associated with many complications affecting sensory, respiratory, and neurological function.

    “Craniosynostosis is important to recognise and treat because it can be associated with many complications affecting sensory, respiratory and neurological function.”
  • The paper relies on this without support.

    Most isolated non-syndromic cases present electively, but a minority of syndromic cases present acutely and require immediate intervention.

    “Most isolated non-syndromic cases present electively, but a minority of syndromic cases present acutely and require immediate intervention.”
  • The paper relies on this without support.

    Single suture synostosis affects the sagittal suture most commonly, followed by the coronal, metopic, and lambdoid sutures.

    “Single suture synostosis affects the sagittal suture most commonly, followed by the coronal, metopic and lambdoid sutures.”
  • The paper relies on this without support.

    Both environmental factors (especially intrauterine fetal head constraint) and genes (single gene mutations, chromosome abnormalities, and polygenic background) predispose to craniosynostosis.

    “Both environmental factors (especially intrauterine fetal head constraint) and genes (single gene mutations, chromosome abnormalities and polygenic background) predispose to craniosynostosis.”
  • The paper relies on this without support.

    Cases with a genetic cause are more likely to be associated with multiple suture synostosis and extracranial complications.

    “Apart from the genetic implications, it is important to recognise cases with a genetic cause because they are more likely to be associated with multiple suture synostosis and extracranial complications.”
  • The paper relies on this without support.

    Some clinically non-syndromic synostosis, usually affecting the coronal suture, can be caused by single gene mutations, particularly the Pro250Arg mutation in FGFR3.

    “As well as being associated with syndromes, some clinically non-syndromic synostosis (usually affecting the coronal suture) can be caused by single gene mutations, particularly the Pro250Arg mutation in FGFR3.”
  • The paper relies on this without support.

    Non-synostotic plagiocephaly is a common condition related to deformation and shear stress on the skull during late pregnancy and delivery, and frequently increases in severity before head control because infants tend to be nursed supine.

    “The latter is a very common condition related to deformation and shear stress on the skull during late pregnancy and delivery, and frequently increases in severity before the acquisition of head control, because infants tend to be nursed in a supine position.”
  • The paper relies on this without support.

    In synostotic plagiocephaly caused by unicoronal synostosis, the ear on the affected side is shifted forward, the distance to the flattened brow contour is reduced, and the skull viewed from above is rhomboid.

    “In synostotic plagiocephaly caused by unicoronal synostosis, the ear on the affected side is shifted forward, and the distance to the flattened brow contour is reduced.The skull when viewed from above is a rhomboid shape.”
  • The paper relies on this without support.

    In non-synostotic anterior plagiocephaly, the ear on the flattened side is more posterior, and the skull viewed from above is parallelogram-shaped.

    “In non-synostotic anterior plagiocephaly, the ear on the flattened side is more posterior (parallelogram shape when viewed from above).”
  • The paper relies on this without support.

    Skull radiographs have significantly lower sensitivity for detecting sutural patency than CT.

    “Skull radiographs are of limited use as their sensitivity for detecting sutural patency is significantly less than CT.”
  • The paper relies on this without support.

    MRI is less good at visualising cranial sutures than CT.

    “Magnetic resonance imaging (MRI), although ideal for the brain, is less good at visualising the cranial sutures.”
  • The paper relies on this without support.

    Heterozygous mutations of FGFR2 cause Apert, Crouzon, and Pfeiffer syndromes.

    “Heterozygous mutations of FGFR2 cause three classical craniosynostosis syndromes, those of Apert, Crouzon and Pfeiffer.”
  • The paper relies on this without support.

    Apert syndrome is characterised by bicoronal synostosis and bilateral symmetrical complex syndactyly of the hands and feet.

    “Apert syndrome is characterised by bicoronal synostosis and bilateral symmetrical complex syndactyly of the hands and feet (Figure 1l).”
  • The paper relies on this without support.

    Pfeiffer syndrome is usually characterised by broad, radially deviated thumbs and/or big toes, sometimes with cutaneous syndactyly, and includes individuals previously classified with Jackson-Weiss phenotype.

    “Pfeiffer syndrome is usually characterised by broad, radially deviated thumbs and/or big toes (Figure 1k), sometimes with cutaneous syndactyly, and includes individuals previously classified with a 'Jackson-Weiss' phenotype.”
  • The paper relies on this without support.

    Crouzon syndrome is usually the mildest of the FGFR2-associated disorders, and clinical diagnosis is suggested by crouzonoid facies and absence of major hand/foot abnormalities.

    “Crouzon syndrome is usually the mildest of the FGFR2-associated disorders and the clinical diagnosis is suggested by the combination of crouzonoid facies (Figure 1n) and absence of major abnormalities of the hands and feet.”
  • The paper relies on this without support.

    The association of crouzonoid facies with acanthosis nigricans is caused by a specific FGFR3 mutation.

    “The association of crouzonoid facies with acanthosis nigricans is caused by a specific FGFR3 mutation (see below).”
  • The paper relies on this without support.

    FGFR3 encodes a protein with a domain structure closely resembling FGFR2.

    “FGFR3 encodes a protein that has a domain structure closely resembling its paralogue FGFR2 (Figure 2b).”
  • The paper relies on this without support.

    Although FGFR3 mutations are commonly associated with bone dysplasia, two heterozygous mutations cause Muenke syndrome and Crouzon syndrome with acanthosis nigricans.

    “Although FGFR3 mutations are commonly associated with bone dysplasia (hypochondroplasia-achondroplasia-thanatophoric dysplasia series), two heterozygous mutations cause specific craniosynostosis syndromes, Muenke syndrome and Crouzon syndrome with acanthosis nigricans (Figure 2b).”
  • The paper relies on this without support.

    Patients with Muenke syndrome usually present with unicoronal or bicoronal synostosis, but at least 20% of mutation carriers do not have clinically significant craniosynostosis.

    “Patients usually present with either unicoronal or bicoronal synostosis, but at least 20% of mutation carriers do not have clinically significant craniosynostosis.”
  • The paper relies on this without support.

    The facial appearance in Muenke syndrome ranges from normal to a dysmorphic appearance easily mistakable for Saethre-Chotzen syndrome.

    “The facial appearance ranges from normal to a dysmorphic appearance easily mistakable for Saethre-Chotzen syndrome.”
  • The paper relies on this without support.

    Minor digital abnormalities, especially brachydactyly, are not characteristic of Muenke syndrome.

    “Minor digital abnormalities (especially brachydactyly) are not characteristic and there should be a low threshold for requesting the genetic test to establish the diagnosis.”
  • The paper relies on this without support.

    Crouzon syndrome with acanthosis nigricans is characterised by the Ala391Glu substitution.

    “Crouzon syndrome with acanthosis nigricans is characterised by the Ala391Glu substitution.”
  • The paper relies on this without support.

    Acanthosis nigricans in Crouzon syndrome develops during childhood and is usually not apparent at presentation.

    “The acanthosis nigricans, which develops during childhood, is usually not apparent at presentation, so specific testing should be requested in the diagnostic workup of Crouzon syndrome.”
  • The paper relies on this without support.

    Saethre-Chotzen syndrome is characterised by heterozygous mutations of TWIST1, which encodes a basic helix-loop-helix transcription factor.

    “Saethre-Chotzen syndrome is characterised by heterozygous mutations of TWIST1, which encodes a transcription factor belonging to the basic helix-loop-helix family (BHLH motif, Figure 2c).”
  • The paper relies on this without support.

    Affected individuals with Saethre-Chotzen syndrome usually present with unicoronal or bicoronal synostosis, but non-penetrance for craniosynostosis occurs.

    “Affected individuals usually present with unicoronal or bicoronal synostosis, but non-penetrance for craniosynostosis occurs.”
  • The paper relies on this without support.

    Abnormal extremities in Saethre-Chotzen syndrome (broad, laterally deviated first digits, 2/3 cutaneous syndactyly, brachydactyly) are variable and only occasionally diagnostic.

    “Abnormal extremities (broad, laterally deviated first digits, 2/3 cutaneous syndactyly and brachydactyly) are variable and only occasionally diagnostic.”
  • The paper relies on this without support.

    Craniofrontonasal syndrome is an X-linked disorder that presents paradoxically with heterozygous females more severely affected than hemizygous males.

    “Craniofrontonasal syndrome is an X-linked disorder that presents paradoxically with heterozygous females more severely affected than hemizygous males.”
  • The paper relies on this without support.

    The encoded protein ephrin-B1 is involved in cell recognition, so cells expressing it tend to group together (homophilic sorting).

    “The encoded protein ephrin-B1 (which comprises an EPH domain that interacts with Eph receptor tyrosine kinases, single pass transmembrane (TM) sequence and intracellular PDZ (protein interaction) domain) is involved in cell recognition, so that cells expressing the molecule tend to group together (homophilic sorting).”
  • The paper relies on this without support.

    The heterozygous FGFR1 mutation encoding Pro252Arg occurs at the equivalent position to Apert (FGFR2) and Muenke (FGFR3) mutations.

    “The heterozygous FGFR1 mutation encoding Pro252Arg occurs at the equivalent position in FGFR1 to the Apert (FGFR2) and Muenke (FGFR3) mutations.”
  • The paper relies on this without support.

    The FGFR1 Pro252Arg mutation is an unusual cause of Pfeiffer syndrome, accounting for fewer than 10% of cases.

    “However it is an unusual cause of Pfeiffer syndrome accounting for fewer than 10% of cases.”
  • The paper relies on this without support.

    A wide variety of chromosome abnormalities have been associated with craniosynostosis, many in single cases only.

    “A wide variety of chromosome abnormalities have been associated with craniosynostosis, many in single cases only.”
  • The paper relies on this without support.

    Craniosynostosis is recognised as a low frequency association of the 22q11.21 microdeletion.

    “Craniosynostosis is recognised as a low frequency association of the 22q11.21microdeletion.”
  • The paper relies on this without support.

    No cases of TWIST1 mosaicism have been reported.

    “Mosaicism for TWIST1 mutations, although theoretically possible, has not been reported”
  • The paper relies on this without support.

    The number of de novo TWIST1 mutations studied is relatively small.

    “the sample size of de novo TWIST1 mutations is relatively small”
  • The paper relies on this without support.

    Most cases of craniosynostosis, even syndromic ones, go undetected in pregnancy.

    “the majority of even syndromic craniosynostosis is not detected during the pregnancy”
35 of 35

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Flagged first, then by citations

Show all 51 references

Cited by

Sorted by citations

See all 499

Metadata

Authors
Johnson, D., & Wilkie, A. O. M.
Affiliations
John Radcliffe Hospital (GB)
Corresponding author
Wilkie, Andrew O M
Venue
European Journal of Human Genetics
Published
2011-01-19
Volume
19
Issue
4
Pages
369-376
ISSN
  • 1018-4813 (ISSN-L)
  • 1476-5438
OpenAlex
W4231119834
Cited by
499
References
51
Citations by year
2026: 38 · 2025: 35 · 2024: 45 · 2023: 42 · 2022: 40 · 2021: 43 · 2020: 32 · 2019: 38 · 2018: 33 · 2017: 35 · 2016: 23 · 2015: 24 · 2014: 23 · 2013: 26 · 2012: 14
FWCI
12.66
Type
journal article
Language
en
Open access
Locations
  • European Journal of Human Genetics (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Wellcome Trust
  • National Institute for Health and Care Research
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Surgery › Craniofacial Disorders and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
  • Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
Keywords
craniosynostosis, cranial sutures, premature suture fusion, single-gene mutations, chromosomal abnormalities, genetic diagnosis, pediatric patients
MeSH terms
Child, Chromosome Aberrations, Cranial Sutures, Craniosynostoses, Female, Genetic Counseling, Humans, Male, Mutation, Nuclear Proteins, Prenatal Diagnosis, Tomography Scanners, X-Ray Computed, Risk Assessment, Ephrin-B1, Receptor, Fibroblast Growth Factor, Type 1, Receptor, Fibroblast Growth Factor, Type 2, Receptor, Fibroblast Growth Factor, Type 3, Twist-Related Protein 1

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Cited sources are checked with a language model’s help (gpt-6-sol).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review