Thalassaemia: with hair on end sign

Case contributed by Dr Nauman Akram


Known thalassaemia

Patient Data

Age: 12 years
Gender: Female

Lateral skull radiograph demonstrates a widened diploic space and vertical striations running perpendicularly giving rise to the characteristic hair-on-end appearance.

Case Discussion

Hair-on-end appearance refers to the radiological pattern of elongated trabeculae in a widened diploic space. This represents calcified spicules perpendicular to the bone surface, corresponding to a periosteal reaction to disturbed bone, calvarial thickening and thinning of the inner table.

This is classically seen in children and adolescents with haemolytic anaemias such as thalassaemia.

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Case information

rID: 54519
Published: 13th Jul 2017
Last edited: 29th Nov 2017
Inclusion in quiz mode: Included

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