How is Pagets Disease of Bone diagnosed?
PDB is a radiographic diagnosis and can be made with plain x-ray. Typical findings of PDB on radiograph include focal osteolysis with sclerotic changes, thickening of the cortex, coarse trabecular pattern, and bone enlargement. ALP should be measured, which is often, though not always, elevated.
The characteristic radiographic and scintigraphic findings seen in Paget’s disease of bone.
- (A) A skull radiograph shows a thickened cranium with regions of dense sclerosis and osteopenia resulting in a “cotton wool” appearance.
- (B) A pelvic radiograph shows right hemipelvic loss of normal trabeculation, sclerosis, and cortical thickening, along with sclerosis of the iliopectineal line.
- (C) Full-body scintigraphy shows increased uptake in the skull, pelvis, lumbar spine, bilateral femurs with bowing of the right, tibias, scapula, and bilateral proximal humerus.
