American Academy of Pediatrics – Section on Neurological Surgery

View all recommendations from this society

March 15, 2021

Do not perform routine imaging for evaluation of infant head shape.

Routine imaging for the evaluation of infant head shape is not necessary. It exposes the child to unnecessary radiation. Positional plagiocephaly can be diagnosed on clinical examination. Most craniosynostosis presentations can also be discerned on clinical examination. Imaging may be obtained by specialists to make the diagnosis in complex cases and, if necessary, for surgical planning.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The pediatric neurosurgery Choosing Wisely topics were chosen after discussion among the Section on Neurological Surgery (SONS) Executive Committee members regarding the most common pediatric neurosurgery issues and treatments general pediatricians see in their practices. Various expert committees and sections of the AAP reviewed and approved the list. The AAP Executive Committee then granted final approval of the list.

AAP’s disclosure and conflict of interest policy can be found at


Flannery AM, Tamber MS, Mazzola C, et al. Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for the Treatment of Pediatric Positional Plagiocephaly. Schaumburg, IL: Congress of Neurological Surgeons; 2016. Available at: