Thalassaemia: with hair on end sign
A young girl with the known thalassemia
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Radiograph skull Lateral view demonstrates widened diploic space and vertical striations running perpendicularly giving rise to the characteristic hair on end appearance.
Hair on end appearance refers to the radiologic pattern of elongated trabeculae in widened diploic space which represent as calcified spicules perpendicular to the bone surface, corresponding to a periosteal reaction to disturbed bone, calvarial thickening and thinning of the inner table; classically seen in children and adolescents with hemolytic anemias such as thalassemia.