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Collaborative Hypertext of Radiology

Musculoskeletal system



Paget disease

disease of unknown etiology involving destruction and reparation

  • age > 40y; M:F 2:1

  • skull
    • osteoporosis circumscripta (outer table destroyed only)
    • "cotton wool" appearance
    • increased hat size!
  • spine
    • monostotic vertebral involvment usually
  • pelvis
    • affected in 2/3 cases
    • consists of cortical thickening
    • enlargement of pubis/ischium
    • coarse trabecular pattern
  • extremities
    • "blade of grass" appearance

  • elevation of alk phos (up to 20X), normal calcium, normal phosphorus

  • complications:
    • path fractures in 8% cases (usu. femur = "shepard's crook")
    • malignant degeneration (usu. osteosarcoma-50%, fibrosarcoma-25%)

Brian Funaki, MD  -  6 February 1995
Last updated:  1 October 2013


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Copyright © 2013, Charles E. Kahn, Jr.