All are radiological features of sickle cell anemia except – a) Vertebra planab) Floating teethc) Bone infarctd) Marrow hyperplasiae) Secondary osteomyelitis

**Core Concept**
Sickle cell anemia is a genetic disorder characterized by the production of abnormal hemoglobin (HbS), which causes red blood cells to become misshapen and prone to premature destruction. Radiological features of sickle cell anemia are a result of chronic hemolysis, vaso-occlusion, and bone marrow hyperplasia.

**Why the Correct Answer is Right**
Sickle cell anemia is associated with characteristic radiological features, including **bone infarcts** due to vaso-occlusion and subsequent ischemia, **marrow hyperplasia** as a compensatory response to chronic anemia, **vertebra plana** resulting from infarction of the vertebral bodies, and **secondary osteomyelitis** due to increased susceptibility to infections. **Floating teeth**, however, are not a typical feature of sickle cell anemia.

**Why Each Wrong Option is Incorrect**
**Option A:** Vertebra plana is a recognized radiological feature of sickle cell anemia, resulting from infarction of the vertebral bodies.
**Option B:** Floating teeth are more commonly associated with conditions such as hyperparathyroidism or osteogenesis imperfecta, not sickle cell anemia.
**Option C:** Bone infarcts are a well-documented complication of sickle cell anemia, resulting from vaso-occlusion and ischemia.
**Option D:** Secondary osteomyelitis is a known complication of sickle cell anemia, due to increased susceptibility to infections.

**Clinical Pearl / High-Yield Fact**
When evaluating radiological features of sickle cell anemia, it's essential to consider the patient's clinical history and laboratory findings, as these features can be nonspecific and require a high index of suspicion for diagnosis.

**Correct Answer:** B. Floating teeth