# Salt and pepper appearance in radiograph is seen in:
A. Osteoporosis
B. Osteopetrosis
C. Sickle cell anemia
D. Thalassemia
The correct answer is D. Thalassemia.
"Crew - cut" or "Hair - on - end" appearance of skull is characteristic of both sickle cell anemia and thalassemia. In thalassemia radiographs of maxilla and mandible shows characteristic apparent coarsening of some trabeculae and the blurring and disappearance of others, resulting in "salt and pepper" effect.
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