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Paget disease

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Fall with left hip pain

Patient Data

Age: 80 years
Gender: Female
x-ray

Extensive trabecular thickening and expansion of the pelvis and proximal right femur characteristic of Paget disease. No acute fracture is seen

x-ray

Pagetoid change of the left humerus. Lungs are clear. Hiatus hernia. 

ct

Paget disease involving the pelvis and right neck of femur. Note is also made of probable Paget disease within L4 and L5 vertebral bodies. Other findings include chronic diverticulosis.

99mTc MDP

Nuclear medicine

Whole body delayed images demonstrate intense tracer activity consistent with moderately active Paget disease in the left humerus, pelvic girdle, right femur, thoracic spine, lumbar spine and sacral spine region.

Case Discussion

Paget disease of the bone is a common, chronic bone disorder characterized by excessive abnormal bone remodeling. It frequently affects the pelvis and proximal long bones and has characteristic radiographic features, which in the pelvis and long bones is cortical thickening and sclerosis. 

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