Hair on end sign
A young girl with known history of repeated blood transfusions presented with severe anemia.
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Radiograph skull AP and Lateral views showing widened diploic space and vertical striations running perpendicularly in diploic space giving rise to characteristic hair on end appearance.
Skeletal findings in chronic hemolytic disorders are manifestations of extra-medullary hematopoiesis.
Extra-medullary hematopoiesis manifests in spine as paravertebral masses.
In skull it manifests as widened diploic space and vertical striations running in diploic space giving rise to characteristic hair on end sign.