What abnormalities are present?
The main finding is thickened cortex in the left femur. More subtle signs include coarse trabeculations and an expanded femoral head. Importantly, several stress fractures can be seen in the lateral cortex of the shaft.
Where else can signs of Paget disease be found?
Skull, spine and pelvis are common sites for Paget associated changes, with lytic then mixed then sclerotic changes. Multiple sites are likely to be affected, favoured over monostotic disease.
What would you expect to see on a blood test profile?
The typical marker of Paget disease is a normal calcium and phosphorous, with an elevated alkaline phosphatase (ALP) reflecting the osteoclastic and osteoblastic activity.
Coarse trabeculations and expanded femoral head.
Thickened, irregular femoral shaft cortex with several stress fractures.
Distal femur is normal in appearance.