Salt and pepper sign (skull)

Last revised by Daniel J Bell ◉ on 30 Oct 2024

Citation, DOI, disclosures and article data

Citation:

Niknejad M, Bell D, Gaillard F, et al. Salt and pepper sign (skull). Reference article, Radiopaedia.org (Accessed on 28 Mar 2025) https://doi.org/10.53347/rID-21561

DOI:

https://doi.org/10.53347/rID-21561

Permalink:

https://radiopaedia.org/articles/21561?embed_domain=external.radpair.com%2527%255B0%255D%2527%255B0%255D

rID:

21561

Article created:

31 Jan 2013, Mohammad Taghi Niknejad ◉

Disclosures:

At the time the article was created Mohammad Taghi Niknejad had no recorded disclosures.

View Mohammad Taghi Niknejad's current disclosures

Last revised:

30 Oct 2024, Daniel J Bell ◉

Disclosures:

At the time the article was last revised Daniel J Bell had no financial relationships to ineligible companies to disclose.

View Daniel J Bell's current disclosures

Revisions:

17 times, by 13 contributors - see full revision history and disclosures

Systems:

Central Nervous System, Head & Neck, Musculoskeletal

Sections:

Signs

Tags:

cases, stub, sign

Synonyms:

Salt and pepper skull
Salt and pepper calvaria
Salt and pepper sign of the skull
Salt and pepper sign of the calvaria
Pepper pot skull
Pepperpot skull
Salt and pepper appearance

Salt and pepper sign, also known as pepper pot skull, refers to multiple tiny well-defined lucencies in the calvaria caused by resorption of trabecular bone in hyperparathyroidism. There is a loss of definition between the inner and outer tables of the skull and a ground-glass appearance as well as spotty deossification.

Occasionally, the term is used synonymously (although inaccurately) with the raindrop skull appearance of multiple lytic lesions of multiple myeloma ⁴.