Hair-on-end appearance is associated with which condition?

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Multiple Choice

Hair-on-end appearance is associated with which condition?

Hair-on-end on skull radiographs comes from marked expansion of the marrow due to ongoing hematopoiesis in chronic hemolytic anemia. In beta-thalassemia major, the body keeps making red cells, so the bone marrow enlarges and the skull bones thin, creating numerous vertical striations that look like hair standing on end. This pattern is most strongly associated with thalassemia. The other conditions listed don’t typically produce this skull appearance: sickle cell disease can cause other types of skull changes from marrow expansion, but the hair-on-end sign is a classic hallmark of thalassemia; congenital syphilis and hemophilia don’t produce this radiographic pattern.

Hair-on-end on skull radiographs comes from marked expansion of the marrow due to ongoing hematopoiesis in chronic hemolytic anemia. In beta-thalassemia major, the body keeps making red cells, so the bone marrow enlarges and the skull bones thin, creating numerous vertical striations that look like hair standing on end. This pattern is most strongly associated with thalassemia. The other conditions listed don’t typically produce this skull appearance: sickle cell disease can cause other types of skull changes from marrow expansion, but the hair-on-end sign is a classic hallmark of thalassemia; congenital syphilis and hemophilia don’t produce this radiographic pattern.

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