THE OCCURRENCE of roentgenographic changes in the skull in association with congenital hemolytic anemia is well documented. These changes result from increased proliferation of hematopoietic tissue in the bone marrow of the skull and are characterized by widening of the diploic spaces and displacement externally of the outer table which may be thinned or completely atrophied. The diploic trabeculae may assume a position perpendicular to the inner table presenting a radial pattern which, when advanced, is called an appearance of hair-standing-on-end. Whereas these are the classical radiological appearances of the skull in congenital hemolytic anemia, similar changes have been described in chronic iron-deficiency anemia.
Sheldon1 in 1936 was the first to draw attention to the association of skull changes in iron-deficiency anemia. He described an infant of 2 years, 4 months who had bossing of the frontal and parietal bones with radiological changes. The infant was anemic with a