Presentation
Lumbar back pain
Patient Data
The L4 vertebra demonstrates cortical thickening, thickened trabeculae, and slightly increased size compared to other vertebrae in keeping with vertebral Paget disease. The predominantly peripheral calcification within the L4 vertebral body creates a picture frame appearance. The left iliac bone also demonstrates a pagetoid appearance.
Paget disease of the L4 vertebra. Note the picture frame appearance of the vertebral body on some of the sagittal slices, and the preserved fatty density of the marrow (-35 HU) helping to exclude malignant infiltration of the vertebral body as a differential diagnosis.
Case Discussion
A case of vertebral Paget disease with somewhat of a picture frame appearance to the vertebral body.