MRI confirms the plain film findings and like the CT it shows nicely how the fat signal within the marrow is maintained. This would not be the case if the lytic process was due to metastasis or myeloma where the marrow signal on T1 would be expected to be very low. During the later phases of Paget disease the marrow signal typically become altered due to a fibrous process, however during the early lytic phase seen here the marrow fat signal is preserved.