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.