Chronic

Hematological
Disorders
{
 THALASSEMIA MAJOR
 Marrow proliferation consists of expansion of the
 medulla,thinning of cortical bone and resorption of cancellous
 bone resulting in generalized loss of bone density
 Skull:
 1.hair on end appearance
 2.widening of diploic space
 3.thinning of inner and outer table
 Face:
 1.rodent or chipmunk facies
 2.hypopneumatisation of frontal,maxillary and sphenoid
 sinuses
 3.dental malocclusion
 The ribs may enlarge and the phalanges may become
 rectangular
Generalized loss of bone density is observed
cortex is thinned
trabeculae are coarsened
outline localized lucency
widening of medullary space resulted in squaring of metacarpals
 MULTIPLE MYELOMA
 The two main diffuse patterns in multiple myeloma are:
 1.numerous,well circumscribed ,lytic bone lesions(more
 common)=punched out lucencies(rain drop skull) and
 endosteal scalloping
 2.generalised osteopenia(less common)=often associated
with
 vertebral compression fractures/vertebra plana
 SICKLE CELL ANEMIA
 Skeletal manifestations of sickle cell disease result from
 three interconnected sequealae:
 1.vaso-occlusive crises results in bone
infarcts(medullary
 cavities and epiphysis;H -shaped vertebrae) ,
subperiosteal
 hemorrhages and hand foot syndrome(dactylitis)
 2.chronic anemia resulting in expansion of medullary
spaces
 3.infection(osteomyelitis)
 BONE LYMPHOMA
Primary lymphoma of bone is rare,they may
produce sclerotic bone lesions or they may
cause destruction of bone.