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Paget’s Disease...ull

Paget’s Disease of Bone: Skull

There is marked frontal bossing in this patient with Paget disease. Involvement of the skull in Paget disease can lead to cranial nerve compression, nerve deafness, optic atrophy, and compression of the spinal cord. The bone affected by Paget disease also

Paget's Disease...Leg

Paget's Disease of Bone: Leg

Severe involvement of the tibia in this patient has resulted in bowing.

Paget Disease: Bone

Paget Disease: Bone

In normal medullary bone, the long axis of bone trabeculae lies parallel to lines of stress. Trabeculae are gracefully and symmetrically curved. Blue-staining cement lines (representing successive waves of orderly accretion of new bone) are disposed conce

Paget Disease: Bone

Paget Disease: Bone

In this section of bone, a multinucleated osteoclast is seen in Howship’s lacuna actively resorbing the surrounding bone (hematoxylin eosin, 400x)

Paget Disease: Bone

Paget Disease: Bone

The image on the left shows faintly blue, irregular “cement lines” which result from bone resorption followed by new bone formation. The image on the right shows the same bone section viewed under polarized light. The lamellae on either side of the cement

Paget’s Disease...ull

Paget’s Disease of Bone: Skull

Multiple osteoblastic and osteolytic lesions of the skull are present, giving a "salt and pepper" appearance. Also seen is the characteristic expansion of the diploë.

Paget’s Disease...ull

Paget’s Disease of Bone: Skull

Lateral radiograph of the skull shows typical pagetic changes with a “hair on end” appearance, distorted shape of the skull, thickened calvarium, lytic lesions anteriorly, and “cotton wool” posteriorly with sclerotic changes.

Paget’s Disease...ull

Paget’s Disease of Bone: Skull

Transverse MRI section shows dense mottled pattern of bony thickening of the calvarium and enlarged lateral ventricles of the brain with hydrocephalus.

Paget Disease o...ull

Paget Disease of Bone: Skull

Sagittal MRI view demonstrates thickened calvarium and abnormal bone remodeling with skull deformities. Also seen is “cranial settling” or “basilar invagination,” which when severe can cause hydrocephalus as in this case. Basilar invagination may be deter

Paget Disease o...ips

Paget Disease of Bone: Pelvis and Hips

Extensive osteoblastic and osteolytic lesions are present in the entire pelvis. Thickening of the cortices with coarsening and disorganization of the trabecular pattern can be seen. The pubic rami and ischii are enlarged. Narrowing of the hip joints is un

Paget Disease o...vis

Paget Disease of Bone: Pelvis

Lytic and sclerotic lesions of the pelvis, consistent with Paget's disease, are shown. Bilateral medial joint-space narrowing of the hips is present.

Paget Disease o...rus

Paget Disease of Bone: Humerus

The entire humerus is involved. There is coarsening of the trabecular pattern with thickening of the cortex. Lateral and anterior bowing of the humerus has occurred, a finding usually more marked in large weight-bearing bones such as the femur and tibia.

Paget Disease o...nee

Paget Disease of Bone: Knee

This radiograph shows marked coarsening of the trabeculae with thickening of the cortices of the femur and tibia. Areas of osteolytic change are also present, which often precede irregular, loosely knit new bone formation. These osteolytic and osteoblasti

Paget Disease o...lla

Paget Disease of Bone: Tibia, Fibula and Patella

Sclerotic and lytic lesions of both the tibia and patella are present. There is anterior bowing of the tibia due to bony remodeling. Cortical thickening of the fibula is also present.

Paget Disease (...bia

Paget Disease (Osteitis Deformans): Left Tibia

Left lower limb radiograph shows widespread trabecular disorganization and thickening in the proximal tibia typical of Paget’s disease. The focal area of radiolucency (arrow) in the distal phase is suggestive of the lytic phase of the disease.

Paget Disease: ...rae

Paget Disease: Cervical Vertebrae

This sagittal and coronal images show expanded bone with disordered internal structure in the upper cervical spine, sparing the axis. Pagetic involvement of the cervical spine may cause a myelopathy as well as nerve root compression.

Paget Disease o...vis

Paget Disease of Bone: Pelvis

The areas of increased uptake seen on the bone scan correspond to sclerotic and hypertrophic changes of Paget’s disease in the left hemipelvis and lumbar spine. The axial migration of the left femoral head is typical of Paget’s disease.

Paget Disease o...vis

Paget Disease of Bone: Spine and Pelvis

This bone scan demonstrates increased uptake in the left hemipelvis of a patient with Paget disease corresponding to a localized area of increased bone turnover.

Paget Disease (...bia

Paget Disease (Osteitis Deformans): Left Tibia

Radionuclide bone scan (in same patient as image 06-15-0060) showing the area of increased uptake in the right tibia suggesting active Paget's disease. The whole body scan is useful for picking up other areas of uptake that may be asymptomatic and otherw

 
 
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