Differential diagnosis of pediatric hematologic bone disease

Approach to the differential diagnosis of hematologic bone disease:

  • Hemophilia – affects joints with dense joint effusions, joint space narrowing and epiphyseal overgrowth
  • Thalassemia – affects diploic space with hair on end appearance
  • Osteopetrosis – affects marrow space with osteosclerosis causing bone-within-bone appearance
  • Sickle Cell Disease – bone infarcts cause H-shaped vertebral bodies
  • Leukemia – diffuse infiltration causes diffuse loss of vertebral body height