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CT examination is extremely important in this condition not only for confirming the sutural fusion but also to assess the extent of malformation. What is your observation on the CT images? The striking observation is that the anterior part of the facial structures are poorly developed with very shallow orbits. These patients may come with the popping eyeballs due to dislocation from the sockets so it is extremely important for craniofacial surgeon to quantify this 'shallow orbit' configuration. Pre-op CT is an important element in the planning for and the follow-up of patients after reconstructive surgery

In the subsequent MRI examination which is better suited to identify cord compression, we see diffuse narrowing of the spinal canal, exaggerated at some places. Encroachment of the spinal space is from both the anterior and posterior. This is an indication of hypertrophic or calcified ligamentum flavum. Overall appearance is consistent with diffuse idiopathic skeletal hyperostosis with the spinal canal narrowing at multiple sites.