Skull bossing is a descriptive term in medical physical examination indicating a protuberance of the skull, most often in the frontal bones of the forehead ("frontal bossing"). Although prominence of the skull bones may be normal, skull bossing may be associated with certain medical conditions,[1] including nutritional, metabolic, hormonal, and hematologic disorders.

Frontal bossing

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Frontal bossing in a child
 
Infant Skeleton with Frontal Bossing, A Treatise of the Diseases of Infancy and Childhood by Dr. Job Lewis Smith, 1881

Frontal bossing is the development of an unusually pronounced forehead which may also be associated with a heavier than normal brow ridge. It is caused by enlargement of the frontal bone, often in conjunction with abnormal enlargement of other facial bones, skull, mandible, and bones of the hands and feet. Frontal bossing may be seen in a few rare medical syndromes such as acromegaly – a chronic medical disorder in which the anterior pituitary gland produces excess growth hormone (GH).[2] Frontal bossing may also occur in diseases resulting in chronic anemia, where there is increased hematopoiesis and enlargement of the medullary cavities of the skull.[1]

Associated medical disorders

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References

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  1. ^ a b Dennis, Mark; Bowen, William Talbot; Cho, Lucy (2012). "Frontal bossing". Mechanisms of Clinical Signs. Elsevier. p. 520. ISBN 9780729540759.
  2. ^ "PubMed Health: Frontal bossing".
  3. ^ Nelson Textbook of Pediatrics, 19e. Chapter 48
  4. ^ Kuemmerle-Deschner, Jasmin B; Ozen, Seza; Tyrrell, Pascal N; Kone-Paut, Isabelle; Goldbach-Mansky, Raphaela; Lachmann, Helen; Blank, Norbert; Hoffman, Hal M; Weissbarth-Riedel, Elisabeth; Hugle, Boris; Kallinich, Tilmann; Gattorno, Marco; Gul, Ahmet; Ter Haar, Nienke; Oswald, Marlen; Dedeoglu, Fatma; Cantarini, Luca; Benseler, Susanne M (2016-10-04). "Diagnostic criteria for cryopyrin-associated periodic syndrome (CAPS)". Annals of the Rheumatic Diseases. 76 (6). BMJ: 942–947. doi:10.1136/annrheumdis-2016-209686. ISSN 0003-4967.
  5. ^ Bope, Edward T., and Rick D. Kellerman. "Chapter 13 – Hematology." Conn's Current Therapy: Latest Approved Methods of Treatment for the Practicing Physician. Philadelphia: Saunders Elsevier, 2012.