This study describes the radiological and pathological findings in a necropsy series of 70 skulls of Nigerian patients with sickle cell gene, and 70 controls matched for sex and age with no sickle cell gene. 6 (35%) of the 17 patients with sickle anaemia, or 17% of 35 patients with sickle cell gene excluding the trait, all under age 10 years, were shown to have bone trabeculae within the diploe arranged in stripes parallel to the curvature of the cranial tables on radiography. Histological examination of the skulls with curvilinear stripes showed long trabeculae of bone within the diploe similarly arranged in parallel rows but joint at variable intervals by short bridges of bone. The radiolucent areas between trabeculae corresponded to areas of marrow hyperplasia. A skull radiograph in an African child presenting with this radiological sign should raise the suspicion of sickel cell disease.
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