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Hair on end sign (mnemonic)

Last revised by Mohammad Taghi Niknejad on 17 Aug 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Niknejad M, Skalski M, et al. Hair on end sign (mnemonic). Reference article, Radiopaedia.org (Accessed on 04 Oct 2024) https://doi.org/10.53347/rID-9384

DOI:

https://doi.org/10.53347/rID-9384

Permalink:

https://radiopaedia.org/articles/9384

rID:

9384

Article created:

11 Apr 2010, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

17 Aug 2024, Mohammad Taghi Niknejad ◉

Disclosures:

At the time the article was last revised Mohammad Taghi Niknejad had no financial relationships to ineligible companies to disclose.

View Mohammad Taghi Niknejad's current disclosures

Revisions:

21 times, by 17 contributors - see full revision history and disclosures

Systems:

Musculoskeletal, Vascular, Central Nervous System

Sections:

Signs, Mnemonics

Tags:

mnemonic

Synonyms:

Hair on end appearance (mnemonic)
Hair-on-end sign (mnemonic)
Hair on end appearances (mnemonic)
HI NEST (mnemonic)

The hair on end sign refers to a radiographic appearance of the diploic space of the skull vault which results from a thickening of trabeculae as the diploic space expands. These trabeculae are perpendicular in orientation, interspersed by radiolucent marrow hyperplasia along with skull vault.

It is classically described with plain skull radiographs, although it can also be appreciated on CT or MRI ³. Causes include:

A useful mnemonic to remember the various causes of this sign is:

HI NEST ⁴

Mnemonic

H: hereditary spherocytosis
I: iron deficiency anemia
N: neuroblastoma metastasis
E: enzyme deficiency, e.g. G-6-PD deficiency causing hemolytic anemia
S: sickle cell disease
T: thalassemia major

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