When Lynette holds up two fingers, Tom asks her if she is about to recite the "Girl Scout Oath". The "Girl Scout Promise and Law", as it is called, is recited with three fingers held up.
This is the second season finale episode in which Mary Alice doesn't appear, in which there is no mystery resolution, and in which no major character dies.
Dr. Rushton: I'm glad you came in. We've got your results back and the tests did pick something up.
Lynette: So, it is the cancer. Oh God, I can't go through this again!
Dr. Rushton: No, no, no. Nothing like that. You're pregnant.
Lynette: Excuse me?
Dr. Rushton: About six weeks or so.
Lynette: Are you sure it's not cancer?
This episode marks the last appearance by Neal McDonough (Dave Williams) as a series regular.
This episode marks the 100th appearance by Doug Savant as Tom Scavo.
International Episode Titles:
French: Dans La Peau De Dave Dash (In the Skin of Dave Dash)
Italian: I Tarli Della Mente (The Woodworms of the Mind)
Germany: Showdown (Showdown)
Czech Republic: Kruh se uzavírá (The Circle Is Closing Up)
Latin America: July 8, 2009 on Sony Entertainment Television (a.k.a. Canal Sony).
Australia: August 3, 2009 on Channel 7
The Netherlands: October 20, 2009 on Net5
Finland: October 26, 2009 on Nelonen
Germany: November 25, 2009 on ProSieben
Episode Title: The episode title, "If It's Only In Your Head" is a lyric from the song "Putting It Together" from the 1984 musical Sunday in the Park with George. The full line is 'A vision's just a vision if it's only in your head. If no one gets to see it, it's as good as dead! It has to come to light." The line "A vision's just a vision", taken from the same lyric, was used as the title for another episode earlier this season.