“hair-on-end” pattern in the skull

GAMUT

“Hair-On-End” Pattern in the Skull

By Diane Daly

GENERALIZED

Common 1. Congential hemolytic anemia (including

thalassemia, sickle cell disease, spherocyto- sis, elliptocytosis)

Uncommon 1. Congential cyanotic heart disease with sec-

ondary polycythemia 2. Hypernephroma with increased erythro-

poiesis 3. Iron deficiency anemia, severe 4. Leukemia, lymphoma

From the Department of Radiology, University Hospital, Cincinnati.

Diane Daly: Resident in Radiology. Address reprint requests to Diane D. Daly, MD. Depart-

ment of Radiology, University Hospital, 234 Goodman St. Cincinnati, OH 45267.

Uncommon 1. Ewing’s sarcoma 2. Hemangioma 3. Osteosarcoma

REFERENCES

o 1987 by Grune & Stratton, Inc. 1. Greenfield GB: Radiology of Bone Diseases (ed 4). 0037-l 98X/87/2203-0002$05.00/0 Philadelphia: Lippincott, 1986;104

5. Multiple myeloma 6. Polycythemia vera 7. Red cell enzyme deficiency with secondary

reticulocytosis (eg, pyruvate kinase, hexo- kinase, glucose-6-phosphate dehydroge- nase)

LOCALIZED

Common 1. Meningioma 2. Metastases (especially neuroblastoma,

prostate, breast)

Fig 1. Generalized “hair-on- end” pattern in a 7-year-old child with thalassemia major. Widened diploic space and atrophy of the outer table with perpendicular spicules of spongiosa trabeculae are caused by pressure erosion of the smaller trabeculae by the expanding marrow.

144 Seminars in Roentgenology, Vol XXII, No 3 (July), 1987: pp 144-145

“HAIR-ON-END” PAlTERN IN THE SKULL 145

Fig 2. “Hair-on-end” appearance in adult I vale with meningioma.

an

2. KBhler A, Zimmer EA: Borderlands of the Normal and Early Pathologic in Skeletal Radiology. Orlando, FL: Grune & Stratton, 1968;202

3. Silverman FN: Caffey’s Pediatric X-ray Diagnosis (ed 8). Chicago: Year Book Medical, 1985;79-85

4. Swischuk LE: Differential Diagnosis in Pediatric Radi- ology. Baltimore: Williams and Wilkins, 1984:341-343

5. Wintrobe MM, Thorn GW, Adams RD, et al: Harri- son’s Principles of Internal Medicine (ed 7). New York: McGraw-Hill, 1974;1602-1613