Paget disease of the bone

Case contributed by Dr Sinéad Culleton

Presentation

Presented with left hip and lower back pain.

Patient Data

Age: 65 years
Gender: Male
X-ray

There is sclerosis around the left SI joint, left pubic ramus and ilium and there is a coarse thickened trabecular pattern.

Nuclear medicine

There is increased uptake in the left pelvis in those areas corresponding to the thickened trabecular  pattern seen on the pelvic x-ray, which is due to Paget disease.

Case Discussion

Paget disease of the bone is usually polyostotic and asymmetric. In up to 75% of cases the pelvis is involved.

The classical triad of imaging findings are:

  • increased size of bone
  • thickening of the cortex
  • accentuation of the trabecular pattern

In the pelvis typically the trabeculae of the sacrum and ilium is thickened. The central portion of the ilium can undergo rarefaction and resemble a large lytic lesion. The iliopectineal line may be thickened.

Secondary degenerative joint disease with acetabular protrusio can occur.

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Case information

rID: 40758
Case created: 2nd Nov 2015
Last edited: 2nd Nov 2015
Inclusion in quiz mode: Excluded

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