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Images in Clinical Medicine

Kim Eagle, M.D., Editor

Paget's Disease of Bone

Kenneth J. Simcic, M.D., and Albert J. Moreno, M.D.

N Engl J Med 1996; 334:161January 18, 1996

Article

Figure 1 A 67-year-old man had Paget's disease involving the right tibia and the first lumbar vertebrae. The patient initially presented with bone pain and bowing of his right lower leg, but the vertebral lesion was not symptomatic. An x-ray film of the right tibia (Panel A) and a bone scan obtained after the administration of technetium-99m–labeled methylene diphosphonate (Panel B) show a marked expansion of bone and a bowing deformity in the right tibia. In addition, the x-ray film shows mixed lytic and sclerotic changes typical of chronic Paget's disease. The accumulation of radionuclide in the right kidney on the bone scan was caused by a large renal cyst.

Kim Eagle, M.D.

Kenneth J. Simcic, M.D.
Albert J. Moreno, M.D.
William Beaumont Army Medical Center, El Paso, TX 79920