Paget disease of the femur

Case contributed by Derek Smith
Diagnosis certain

Presentation

Increasing difficulty walking. No trauma or pain. No previous imaging.

Patient Data

Age: 90 years
Gender: Male
x-ray

Coarse trabeculations and expanded femoral head.

Thickened, irregular femoral shaft cortex with several stress fractures.

Distal femur is normal in appearance.

Case Discussion

This patient has presented with Paget disease of the left femur.

This condition typically affects the pelvis, spine and skull, but can affect proximal long bones.

Given the evidence of stress fractures, orthopedic review was arranged and this case was managed conservatively.

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