Patient Data
A coarsened tubercular pattern with cortical thickening, osseous expansion and increased osseous density is observed to involve the bilateral innominate bones and left proximal femur which extends to the distal diaphyseal region.
A coarsened trabecualar pattern with mild osseous expansion and increased vertebral body density is observed involving L1, L3, and L4. These changes are vaguely reminiscent of the picture frame appearance.
A coarsened tubercular pattern with cortical thickening, osseous expansion and increased osseous density is observed to involve the proximal right humerus which extends to the mid diaphyseal region.
Case Discussion
In cases of extensive polyostotic involvement in Paget disease, one should be concerned for high-output cardiac failure and monitor for signs and symptoms of malignant degeneration.
This case is courtesy of the LAC+USC radiology department.