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