Blade of grass sign in Paget's disease

Case contributed by Dr Ivan Turkalj


An elderly female complaining of leg pain. Serum alkaline phosphatase is markedly elevated.

Patient Data

Age: 76
Gender: Female

A well defined and wedge shaped lytic lesion in the right femoral diaphysis is seen, with no evidence of periosteal reaction and cortical disruption.

Case Discussion

Findings are consistent with osteolytic phase of Paget's disease. 

The blade of grass or the flame sign is a wedge- or V-shaped radiolucency typically located in diaphysis of long bones such as femur and tibia.

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Case information

rID: 51018
Published: 1st Feb 2017
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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