Paget’s disease (osteitis deformans)

• etiology isn’t exactly known, but possibly caused by a paramyxovirus

• whatever the cause, it basically wreaks havoc on the normally tightly-coupled processes of bone resorption and formation, making it topsy-turvy

• Paget’s can manifest as the radiograph in the top skull. there is a huge lytic lesion, termed osteoporosis circumscripta. this is the osteolytic phase

• if the formative (osteoblastic) phase takes over, the clinical consequences will probably be different

• sometimes the presentation is not obvious

• characteristically, the vertebrae assume picture-frame deformations

• labs: if there is lots of bone involved, you will have high alkaline phosphatase

Radiographs

• cortex of the femur has a flame-shaped lesion that is typical of Paget’s

• scintigram of bone to determine how much is forming within the femur

• bowing of the tibia secondary to Paget’s

• a femur looks just like renal dystrophy

Category: Pathology Notes