Paget's Disease

This is a case of 68 year old male who presents with hip pain which occurs while playing tennis. A plain radiograph of the pelvis and hips was obtained. This radiograph demonstrates a diffusely sclerotic appearance of the bone. There is expansion of the pubic bones and proximal femur bilaterally with a diffusely sclerotic appearance and diffuse coarsening of the trabeculae. The findings are symetrically bilaterally. There is no evidence of fracture. The patient subsequently went on to have a nuclear medicine bone scan which demonstrated significantly increased uptake of radiotracer. Findings are consistent with Pagets Disease of bone. Pagets most commonly occurs in older patients. Although Pagets can involve any bone in the body, the pelvis is a typical location. Additional differential considerations must include diffuse metastatic disease, which would most commonly be breast cancer in women or prostate cancer in men.