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Paget disease: cotton wool skull

Case contributed by Dr Ian Bickle


Thickening of frontal bone and pain.

Patient Data

Age: 70 years
Gender: Male

Thickened diploe of the skull and ill-defined 'fluffy' sclerotic areas most pronounced in the frontal bone.

Case Discussion

The cotton wool appearance is a plain film sign on the lateral skull radiograph in Paget disease.

The appearances result from widening of the diploe of the skull with thickened, disorganized trabeculae.

Sclerotic ill-defined ''patches'' appear fluffy like cotton wool.

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Case information

rID: 37964
Published: 29th Jun 2015
Last edited: 12th Jan 2020
Inclusion in quiz mode: Included

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