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Paget Disease
Fathima Fijula P. Manzil, MD; Umesh D. Oza, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Paget disease (PD) of bone
              • Disorder of abnormal/excessive bone remodeling characterized by coarse trabeculae, sclerosis, and expansion of ≥ 1 bones
              • Active disease begins with osteolytic phase followed by sclerotic or mixed active phase; inactive or quiescent phase demonstrates sclerotic lesions
              • Although thickened, abnormal bone is weaker and bone deformity or fracture is common
              • a.k.a. osteitis deformans, osteoporosis circumscripta (skull)

          IMAGING

          • General Features

            • Nuclear Medicine Findings

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. Kravets I: Paget's disease of bone: Diagnosis and treatment. Am J Med. 131(11):1298-303, 2018
                                      2. Wassef HR et al: Nuclear medicine imaging in the dentomaxillofacial region. Dent Clin North Am. 62(3):491-509, 2018
                                      3. Ralston SH et al: Pathogenesis of Paget disease of bone. Calcif Tissue Int. 91(2):97-113, 2012
                                      4. Cortis K et al: Imaging Paget's disease of bone--from head to toe. Clin Radiol. 66(7):662-72, 2011
                                      5. Theodorou DJ et al: Imaging of Paget disease of bone and its musculoskeletal complications: review. AJR Am J Roentgenol. 196(6 Suppl):S64-75, 2011
                                      6. Layfield R: The molecular pathogenesis of Paget disease of bone. Expert Rev Mol Med. 9(27):1-13, 2007
                                      7. Installé J et al: (18)F-fluoride PET for monitoring therapeutic response in Paget's disease of bone. J Nucl Med. 46(10):1650-8, 2005
                                      8. Spieth ME et al: Positron emission tomography and Paget disease: hot is not necessarily malignant. Clin Nucl Med. 28(9):773-4, 2003
                                      9. Cook GJ et al: Fluorine-18-FDG PET in Paget's disease of bone. J Nucl Med. 38(9):1495-7, 1997
                                      10. Bahk YW et al: Bone pathologic correlation of multimodality imaging in Paget's disease. J Nucl Med. 36(8):1421-6, 1995
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Clinical Issues

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Definitions

                                                • Paget disease (PD) of bone
                                                  • Disorder of abnormal/excessive bone remodeling characterized by coarse trabeculae, sclerosis, and expansion of ≥ 1 bones
                                                  • Active disease begins with osteolytic phase followed by sclerotic or mixed active phase; inactive or quiescent phase demonstrates sclerotic lesions
                                                  • Although thickened, abnormal bone is weaker and bone deformity or fracture is common
                                                  • a.k.a. osteitis deformans, osteoporosis circumscripta (skull)

                                              IMAGING

                                              • General Features

                                                • Nuclear Medicine Findings

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. Kravets I: Paget's disease of bone: Diagnosis and treatment. Am J Med. 131(11):1298-303, 2018
                                                                          2. Wassef HR et al: Nuclear medicine imaging in the dentomaxillofacial region. Dent Clin North Am. 62(3):491-509, 2018
                                                                          3. Ralston SH et al: Pathogenesis of Paget disease of bone. Calcif Tissue Int. 91(2):97-113, 2012
                                                                          4. Cortis K et al: Imaging Paget's disease of bone--from head to toe. Clin Radiol. 66(7):662-72, 2011
                                                                          5. Theodorou DJ et al: Imaging of Paget disease of bone and its musculoskeletal complications: review. AJR Am J Roentgenol. 196(6 Suppl):S64-75, 2011
                                                                          6. Layfield R: The molecular pathogenesis of Paget disease of bone. Expert Rev Mol Med. 9(27):1-13, 2007
                                                                          7. Installé J et al: (18)F-fluoride PET for monitoring therapeutic response in Paget's disease of bone. J Nucl Med. 46(10):1650-8, 2005
                                                                          8. Spieth ME et al: Positron emission tomography and Paget disease: hot is not necessarily malignant. Clin Nucl Med. 28(9):773-4, 2003
                                                                          9. Cook GJ et al: Fluorine-18-FDG PET in Paget's disease of bone. J Nucl Med. 38(9):1495-7, 1997
                                                                          10. Bahk YW et al: Bone pathologic correlation of multimodality imaging in Paget's disease. J Nucl Med. 36(8):1421-6, 1995