Mediterranean anemia would appear to be of unusual interest to roentgenologists because of the fact that bone changes are characteristic of the disease. There are two types which have come under my personal observation: first, one in which the lesion is found in the negro race (16), being commonly associated with sickle cells (5) in the blood (Fig. 1); and second, the type commonly known as erythroblastic anemia (9), which occurs in races bordering on the Mediterranean, more particularly among the Italians and Greeks (2, 10). One case of the first type and two cases of the second type will be described, and comparison with similar cases reported by other authors is noted. Case 1. J. R., male, aged 6 years, colored, presented a case of sickle-cell anemia. The diagnosis in this case is based entirely upon the X-ray appearances of the skull. This patient was referred to the X-ray Department at St. Luke's Hospital from the Outpatient Department for examination because of a lesion in the lower jaw. X-ray Examination.—A most unusual and remarkable condition, due to the thickening of the middle and outer tables of the skull associated with peculiar radiating lines passing almost at right angles with the inner table of the skull, was revealed. The skull was approximately from one to two inches in thickness at the vertex, this thickening giving it a peculiar shape resembling that of tower skull (Figs. 2 and 3). In fact, the case was regarded as belonging to this category until a paper by Rose (10), of Chicago, brought to my attention the fact that this type of skull was associated with sickle-cell anemia. Dr. Rose and several others, who have examined skulls of this type in which the blood findings have been studied, have agreed with me that this case represents one of sickle-cell anemia, although the findings have not as yet been confirmed by blood examination, and the patient has passed out of observation. I am still making efforts to trace him. Commnent.—This type of lesion has been studied particularly by Cooley, Hahn, Mandeville, Rose, Sosman, Vogt, and Wollstein. In addition to the changes in the cranium, Mandeville describes irregular trabeculations in the pelvis, vertebr, ribs, clavicles, and scapulas. He also describes thinning of the cortex of the long bones, stating that this is an important rather constant finding, and rarefaction of the shafts of the long bones, sometimes referred to as “transparent medulla.” In distinction to the bone changes observed in chloroma, I would call attention to the fact that there are no periosteal changes in sickle-cell anemia, while, in chloroma (3), periosteal changes, in addition to medullary changes, constitute an important radiologic appearance (Fig. 4).