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Paget disease of tibia

Case contributed by Vikas Shah
Diagnosis almost certain


Raised PSA.

Patient Data

Age: 80 years

Bone scan

Nuclear medicine

Diffuse uptake in expanded left tibia, commences from proximal articular surface. 

No abnormal focal uptake to indicate metastatic disease. Degenerative pattern of uptake in spine, shoulders and left first MTP joint.

Left lower leg x-rays


Thickened cortex with coarsened trabeculae involving the left tibia. No fracture. No periosteal reaction or bone destruction.

Case Discussion

There were no specific symptoms localizing to the left tibia. The combination of the x-ray and nuclear imaging findings lead to a diagnosis of Paget disease.

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