Salt and pepper sign (skull)

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Salt and pepper sign or pepper pot skull refers to multiple tiny well-defined lucencies in the calvaria caused by resorption of trabecular bone in hyperparathyroidism. There is a loss of definition between the inner and outer tables of the skull and a ground-glass appearance as well as spotty deossification.

Occasionally, the term is used synonymous (although inaccurately) with raindrop skull appearance of multiple lytic lesions of multiple myeloma ⁴.

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Salt and pepper sign (skull)

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