MSK imaging: thalassaemia skull and bones: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · MSK imaging: thalassaemia skull and bones

Sample item

A child with severe anaemia needing regular transfusions has a skull radiograph showing thickened diploe with perpendicular striations. What is the appearance and cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Hair-on-end appearance from marrow hyperplasia

In thalassaemia major, marrow expansion widens the diploic space and produces radiating spicules. The facial bones also expand with maxillary overgrowth and the long bones show Erlenmeyer flask deformity.

Option by option

  • A. Pepper-pot skull from hyperparathyroidism

    Pepper-pot skull is a feature of hyperparathyroidism.

  • B. Sunburst of osteosarcoma

    A sunburst pattern is a periosteal reaction of tumours.

  • C. Hair-on-end appearance from marrow hyperplasia (correct)

    Correct. Marrow hyperplasia gives the hair-on-end skull.

  • D. Wormian bones from osteogenesis imperfecta

    Wormian bones are sutural bones seen in osteogenesis imperfecta and other conditions.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Hair-on-end appearance from marrow hyperplasia. In thalassaemia major, marrow expansion widens the diploic space and produces radiating spicules.

Why is "Pepper-pot skull from hyperparathyroidism" not the answer?

Pepper-pot skull is a feature of hyperparathyroidism.

Why is "Sunburst of osteosarcoma" not the answer?

A sunburst pattern is a periosteal reaction of tumours.

Why is "Wormian bones from osteogenesis imperfecta" not the answer?

Wormian bones are sutural bones seen in osteogenesis imperfecta and other conditions.

What concept does this question test?

It tests MSK imaging: thalassaemia skull and bones in Radiology. The facial bones also expand with maxillary overgrowth and the long bones show Erlenmeyer flask deformity.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study MSK imaging: thalassaemia skull and bones?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.