Presentation
An elderly female complaining of leg pain. Serum alkaline phosphatase is markedly elevated.
Patient Data
Age: 75 years
Gender: Female
From the case:
Blade of grass sign in Paget disease
Frontal

A well defined, wedge shaped lytic lesion in the right femoral diaphysis is seen, with no evidence of periosteal reaction or cortical disruption.
Case Discussion
Findings are consistent with osteolytic phase of Paget disease.
The blade of grass or the flame sign is a wedge- or V-shaped radiolucency typically located in the diaphysis of long bones such as femur or tibia.