Radiology · single question
A patient with sickle cell anemia presents for dental X-rays. What finding would you MOST expect on a panoramic radiograph?
Show answer and explanation
Correct answer: A. Step-ladder (staircase) pattern of trabecular bone
Sickle cell anemia causes vascular occlusion and bone infarcts, resulting in characteristic radiographic changes including: step-ladder (staircase) trabecular pattern of alveolar bone (coarse, perpendicular trabeculae), generalized osteoporosis, enlarged marrow spaces, and thinning of cortical bone. Other systemic findings include: hair-on-end pattern on skull X-ray. The 'step-ladder' pattern is the classic INBDE answer.
- A. ✅ CORRECT – Sickle cell anemia creates a step-ladder (staircase) trabecular bone pattern on radiographs due to vascular compromise and bone infarction.
- B. ❌ Widened PDL space is a sign of occlusal trauma or periodontal disease — not specific to sickle cell disease.
- C. ❌ Hypercementosis is excessive cementum formation — associated with Paget's disease, not sickle cell disease.
- D. ❌ Ground-glass opacity is characteristic of fibrous dysplasia — not sickle cell anemia.