H-Shaped vertebrae on radiographs are characteristic of which condition?

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Multiple Choice

H-Shaped vertebrae on radiographs are characteristic of which condition?

H-shaped vertebrae are a radiographic sign of bone infarction from vaso-occlusion in sickle cell disease. The central portions of the vertebral endplates become infarcted while the outer ring remains, producing the distinctive H (or Lincoln’s sign) appearance on X-ray. This pattern is classic for sickle cell disease because it directly reflects the ischemic damage caused by abnormal red blood cell flow in the bone. Other conditions produce different bone changes. Thalassemia often shows skull changes from marrow expansion (hair-on-end appearance) due to extramedullary hematopoiesis; congenital syphilis can cause Wimberger sign or saber shin changes; hemophilia typically yields joint bleeds and secondary arthropathy rather than vertebral endplate infarction.

H-shaped vertebrae are a radiographic sign of bone infarction from vaso-occlusion in sickle cell disease. The central portions of the vertebral endplates become infarcted while the outer ring remains, producing the distinctive H (or Lincoln’s sign) appearance on X-ray. This pattern is classic for sickle cell disease because it directly reflects the ischemic damage caused by abnormal red blood cell flow in the bone.

Other conditions produce different bone changes. Thalassemia often shows skull changes from marrow expansion (hair-on-end appearance) due to extramedullary hematopoiesis; congenital syphilis can cause Wimberger sign or saber shin changes; hemophilia typically yields joint bleeds and secondary arthropathy rather than vertebral endplate infarction.

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