Presentation
There is a known, chronic metabolic bone disorder. Asymptomatic at the time of presentation.
Patient Data
Age: 70 years
Gender: Male
From the case:
Paget disease- skull
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There is diploic widening, the inner table is more affected than the outer table.
There are mixed sclerotic and lucent areas.
There is no platybasia, no basilar invagination and no over-riding frontal bone.
Image courtesy: Dr S Mbonane-Nxumalo.
Case Discussion
Features consistent with the known Paget disease of the skull.
The mixed sclerotic and lucent areas give rise to the typical "cotton wool" appearance pathognomonic of the involvement of the skull.
In this instance, the Tam o'Shanter sign is absent.
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