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Paget disease of femur

Case contributed by Smitha Mytheen
Diagnosis almost certain

Presentation

Longstanding right hip pain, now aggravated

Patient Data

Age: 70 years
Gender: Male
mri

Altered signal intensity lesion involving the head, neck and proximal metaphysis of the right femur with hypointense signal on both T1W and T2W images with cortical thickening and bone expansion. There is reduction in size and signal intensity of the medullary cavity.

ct

Expansile lesion of the proximal femur with sclerosis, cortical thickening and coarsened trabeculations. No cortical break or soft tissue component.

Case Discussion

Paget disease is a chronic disorder with extensive remodeling of bone.

Typically affects elderly people, more common in males.

Occurs in three phase 

  1. lytic
  2. mixed
  3. sclerotic

The present case probably represents sclerotic or quiescent phase. Note the bone within bone appearance on CT images.

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