Padgets Disease

Question 1

Padgets Disease

Most commonly greater than ____years at diagnosis
o Rare before 5th decade (40 years)
- MALES MC; ___ to ____ ratio males to females

• Symptoms
  o ____ % of cases are _____ at diagnosis and are
  discovered incidentally
  o Dull, low intensity pain may be associated

 Rest/activity does not appear to have significant effect on pain

Answer 1

55

2:1

Asymptomatic

Question 2

Padgets more common in

Axial Skeleton or Appendicular ?

Answer 2

Axial

Question 3

Long Bone Physical Findings in Paget’s Disease

Bowing deformity of____ bones, especially ____ _____

Bones may be enlarged

 Increasing hat size, shoe size may be noted

Answer 3

long bones

Weight bearing

Question 4

Helpful Lab Tests for Pagets

o S_____A___ phosphatase extremely elevated (20x)

o Found in Urine – H__________

• Most Common Complication- ________ fx – due to long
  bones being soft/weak

Answer 4

o Serum alkaline phosphatase

Hydroxyproline
- Most Common Complication

o Pathological fracture – long bones are soft/weak

Question 5

4 Phases of Paget’s Disease

o L, B, M, M(rare)

In making differential diagnosis, look for bone ________, _______thickening, and coarse trabeculae

Answer 5

Lytic
Blastic
Mixed
Malignant (Rare)

Look for bone expansion, cortical thickening

Question 6

• Vertebra outlined by thickened cortex?

Answer 6

Picture frame vertebra

Question 7

Sharply defined lytic pattern in skull?

Answer 7

Osteoporosis Circumscripta

Question 8

Sharply defined lytic process in long bone?

Answer 8

Blade of grass sign

Question 9

• Fluffy blastic changes in skull?

Answer 9

Cotton-woll skull