** 1. As age is 22 months, thus probably anterior fontanelle is generally the last to close between 18 months and 2 years of age [as you have not mentioned the fontanelle]. In some cases there are numerous causes of a delayed fontanel closure for examples achondroplasia, hypothyroidism, Down syndrome, increased intracranial pressure, and rickets. 2. blood report shows iron deficiency anemia [which is the most common cause in pediatric childhood], requires physical examination [cardiovascular and skeletal system], alkaline phosphatase is raised which is high due to bone problem or physiologically due to AGE. 3. If fontanelle is bulging [inflammation], shrunken [dehydration], enlarged [hydrocephalus], it requires other investigations to confirm the diagnosis. [which is not provided in the history, or your Pediatric Doctor might have ruled out the same] PS: A physical examination will help the physician to determine which imaging technique, such as plain films, ultrasonography, computed tomographic scan, or magnetic resonance imaging, is to be used for diagnosis. Consultation with a pediatric neurosurgeon should be considered if the diagnosis or presence of an abnormality is unclear.