This article summarizes the current state of diagnostic modalities for infant craniofacial deformities and highlights capable diagnostic tools available currently to pediatricians.

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Deformational plagiocephaly is a common diagnosis encountered by pediatricians in the first year of life. Subjective clinical examination and documentation is the most common method for identifying and monitoring the evolution of head shape and determining treatment or the decision to refer to a specialist.


In this systematic review (PROSPERO; CRD42021224842), we aim to compile the evidence for non-radiographic screening and monitoring modalities for deformational plagiocephaly in infants to support pediatricians in achieving earlier diagnosis and more objective monitoring.


A systematic review of the literature was conducted using OVID Medline, Embase, and Web of Science.


Articles pertaining to the use or evaluation of diagnostic modalities for plagiocephaly in infants published between January 1990 and August 2021.


Data on diagnostic accuracy, time-to-diagnosis, reliability, and outcomes for each modality were collected as available by two independent reviewers.


A total of 22 studies were included. We identified 5 unique head shape monitoring technologies: anthropometry, plagiocephalometry, 3D laser scanning, digital photographic, and 3D photogrammetry. Smartphone and artificial intelligence integration have increased in plagiocephaly and craniosynostosis screening and monitoring tools.


Inconsistent reporting both inter- and intra-modality hindered meaningful comparison between screening tools. Substantial heterogeneity in measured outcomes, study design, and population size made cross-study comparisons difficult.


A growing list of quantitative diagnostic modalities for head shape monitoring are becoming accessible to pediatricians. The introduction of artificial intelligence to 3D photogrammetry and digital photography with easy-to-use smartphone applications seems promising for future diagnostic efficiency.

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