Paget disease of the bone is a common, chronic bone disorder characterised by excessive abnormal bone remodelling. The classically described radiological appearances are expanded bone with a coarsened trabecular pattern. The pelvis, spine, skull, and proximal long bones are most frequently affected Paget disease of the breast, which is also known as Paget disease of the nipple, has traditionally been described as a form of breast malignancy characterized by infiltration of the nipple epidermis by malignant cells Abstract PAGET'S osteitis deformans is usually described as a chronic, slowly progressive disease involving one or more bones of the body and causing certain structural changes which result in an increase of size and thickness Paget disease is characterized by infiltration of the epidermis of the nipple by malignant cells called Paget cells. A Paget cell is a large round or ovoid cell with pale, clear, abundant cytoplasm and an enlarged pleomorphic and hyperchromatic nucleus that invades the epidermis (Fig 1) (10)
Paget-Schrötter syndrome, alternatively spelled Paget-Schroetter syndrome and also known as effort thrombosis, refers to primary thrombosis of the axillary and/or subclavian vein. It can be thought of as a venous equivalent of thoracic outlet syndrome - i.e venous thoracic outlet syndrome Radiography is traditionally considered the initial imaging examination for diagnosing Paget disease of bone. The lytic, or incipient active, phase of the disease is characterized by intense osteoclastic activity that is exhibited on radiographs as osteolysis Paget disease (PD) is a chronic metabolically active bone disease, characterized by a disturbance in both bone modeling and remodeling secondary to increased osteoblastic and osteoclastic activity. PD of bone can be a monostotic (single bone) or polyostotic (multiple bones) nonhormonal disorder
The radiographic features of Paget disease correspond to the pathologic processes in the bone and depend on the stage of the disorder Paget's Disease -- pelvis. Frontal radiograph of the pelvis demonstrates the classical triad of thickening of the cortex (blue arrow), accentuation of the trabecular pattern (red circle) and increased density of the bone. For additional information about this disease, click on this icon above. For this same photo without the arrows, click her . The lumbar vertebral body has thickened cortices which outline the body (picture-frame appearance) (red arrows). The vertebral body is slightly larger than the body above and below it (white double arrow). The trabecular pattern is thickened and coarsened (yellow arrow) A comparison of bone scanning and radiology in the assessment of patients with symptomatic Paget's disease. Eur J Nucl Med 1980; 5:417-421 [Google Scholar] 47 Paget's disease predominantly involves the axial skeleton and proximal long bones. Normal bone scan image highlighting (red circles) the most common sites of Pagetic involvement. These include the skull, the humerus, ribs, spine, iliac bone, femur, and tibia. The pelvis is the most common site of involvement, followed by spinal involvement
Paget's Disease (Osteitis Deformans) a) Incidence b) Location c) Types d) Radiographic Features 5. a) Incidence : -Chronic bone disorder characterised by excessive abnormal bone remodelling -It is relatively common in older adults, can affect up to 4% of individuals over 40 and up to 11% over the age of 80 -Usually polyostotic and asymmetrical 6 Diagnostic imaging of Paget's disease of bone should provide more than a diagnosis. It should aim at assessing the distribution of the lesions, their degree of activity, their potential complications and their response to therapy. This goal can be reached by using simple methods (bone scintigraphy a
Methods used to diagnose Paget's disease; After the diagnosis; For your information; Methods used to diagnose Paget's disease. Three tests - an x-ray, blood test, and bone scan - are commonly used to discover Paget's disease. Sometimes the disease is found by accident when one of these tests is done for another reason. X-rays are used. Although Paget disease is diagnosed economically with conventional radiography, MR imaging is well suited for demonstrating the presence and extent of several characteristic disease complications, including basilar impression, spinal stenosis, and secondary neoplasm
This article explores the different imaging modalities used in the assessment of Paget's disease of bone in its different phases. The relative merits of each imaging modality is discussed with illustrative examples, in particular with respect to radiographs, nuclear medicine bone scan, computed tomography (CT) and magnetic resonance imaging (MRI) Paget disease is the second most common bone disease after osteoporosis that affects elderly persons in the United States. We revisit Paget disease of bone and present the gamut of imaging findings associated with this skeletal dis-order, both uncomplicated and complicated. Conclusion Paget disease of bone shows a plethora of imaging pat
He or she may also order X-rays and blood tests that can help confirm the diagnosis of Paget's disease of bone. Imaging tests. Bone changes can be revealed by: X-rays. The first indication of Paget's disease of bone is often abnormalities found on X-rays done for other reasons. X-ray images of your bones can show areas of bone breakdown. Iowa Radiology occasionally supplies links to other web sites as a service to its readers and is not in any way responsible for information provided by other organizations. Sources Paget Disease of the Breast. Cancer.gov. National Cancer Institute, 10 April 2012. Web. 4 Nov 2016. Paget's Disease of the Breast Paget disease of the bone (also known as osteitis deformans) is a chronic bone disorder characterized by excessive abnormal bone remodeling. It can affect up to 4% of individuals over 40 and up to 11% over the age of 80 years. This case shows it in a less common location in the distal fibula Paget disease, a relatively common bone disorder, is a chronic, progressive disturbance in bone metabolism that primarily affects older persons. It is slightly more common in men than in women (3:2), with an average age of onset between 45 and 55 years, although the disease has been known to occur in young adults The radiographic and histopathological image presentation in Paget disease of bone is pathognomonic. Coarse bone structure is generally limited to one bone or one part of a bone, e.g. proximal femur or single vertebra. In the presented case, the bony changes are extensive and breach over joints, not typical for Paget disease
Radiology 189:89-94 (PMID: 8396786).  Sripathi S, Ayachit A, Kadavigere R, et al (2015) Spectrum of imaging findings in Paget's disease of the breast—a pictorial review. Insights Imaging 6:419-429 (PMID: 26142549) Imaging Modality of Choice for Paget's Disease of Bone Many of the characteristic radiographic features of Pagets disease of bone can be seen on CT and MR imaging. However, CT is usually the modality of choice as it can show complex structures in cross-sectional images, including nerve compression and sarcomatous involvement It is now known that Paget's disease of the bone is a non-inflammatory, metabolic disorder of unknown aetiology. The symptoms depend on the bones involved, the most common clinical manifestations being pain at the affected bone and nearby joints. Most patients are entirely asymptomatic. The diagnosis is usually radiological, by means of plain. INTRODUCTION. Paget's disease (PD) of the bone was first described, in 1877, by Sir James Paget under the term osteitis deformans. It is characterized by rapid bone resorption and deposition, resulting in formation of numerous reversal lines, which give rise to a mosaic pattern in the lamellar bone with profuse local vascularity and fibrous tissue in the marrow.[
. Frontal radiograph of the pelvis demonstrates the classical triad of thickening of the cortex (blue arrow), accentuation of the trabecular pattern (red circle) and increased density of the bone. For additional information about this disease, click on this icon above. For this same photo without the arrows, click her Node-negative in this case. The scaly skin irritation is the key to the diagnosis. Be aware that it could indicate a sinister abnormality in the breast deep to the nipple. Look at the technologist worksheet for this observation. The Paget who described this disease in 1875 is the same Paget of bone disease fame Paget-Shroetter syndrome is a subtype of TOS characterized by effort thrombosis of the axillary-subclavian vein. The clinical presentation typically consists of acute upper-extremity swelling, cyanosis, and pain. PSS can be diagnosed with duplex sonography, although venography is more diagnostically sensitive and provides an opportunity for.
. The patient is frequently entirely assymptomatic and the condition can be discovered after routine Xrays, requested for other reasons Paget's Disease of Bone. This patient aged 70 years male with history of CABG and bone pains exhibits cotton wool appearance, widened diploae, coarse trabecular pattern of the left femur, not so classical picture frame of L2 vertebral body, nonhomogenous presentation of left sacral ala. Diagnosis- Pagets disease of the bone Paget disease of the breast (also known as Paget disease of the nipple and mammary Paget disease) is a rare type of cancer involving the skin of the nipple and, usually, the darker circle of skin around it, which is called the areola. Most people with Paget disease of the breast also have one or more tumors inside the same breast
Paget's Disease is an idiopathic condition of abnormal bone remodeling with normal bone being replaced through an active interplay between excessive bone resorption and abnormal new bone formation. The condition typically present in patients age > 40 with asymptomatic lesions discovered incidentally on radiographs erative imaging and histopathology of Paget's dis-ease of the nipple (PDN) determine the available treatment options and probable prognosis. Paget's disease of the nipple is an uncommon presentation of underlying breast carcinoma and is observed in 0.7-4.9% of all breast cancers. Although Velpeau first described eczematou Paget's disease is characterized by active remodeling of bone; its radiologic characteristics follow the transformation of the gross and microscopic anatomy that occurs in both cortical and cancellous bone. Bone is ultimately remodeled into a coarse trabeculated pattern that when pieced together characterizes the mosaic architecture that. Juan E. Small, in Neuroradiology, 2019 Introduction. Paget's disease, or osteitis deformans, is a chronic metabolic disorder characterized by increased bone turnover and breakdown secondary to excessive and disorganized osteoclastic and osteoblastic activity (Fig. 48.1).The precise etiology is still unclear. The excessive breakdown of bone is followed by the formation of weak and abnormal bone Neuropathic arthropathy/Charcot disease most commonly affects the foot in diabetics. Osteoporosis is the most common metabolic disease of bone - see previous page. Other metabolic diseases affecting the bones and joint include osteomalacia, Paget's disease, and neuropathic arthropathy (also known as Charcot's disease)
Paget's disease is a chronic disorder of the skeletal system. Its origin is not definitely known. However the current thinking is that a slow virus may be the initiating factor. The disease affects 3-4% of the population over the age of 40 but ıt is more frequently found in the elderly In patients with back pain, magnetic resonance imaging and computed tomography have been particularly useful in defining the extent of degenerative arthritis, spinal stenosis, and nerve-root impingement. 10 An increase in the size of a vertebral body is one of the radiographic hallmarks of Paget's disease of the spine, which can be particularly. Paget's sarcoma is a rare and particularly aggressive tumour arising within pagetic bone, affecting approximately 1% of patients with Paget's disease during the course of their disease. Most of these tumours are osteosarcomas, but the age profile, skeletal distribution and clinical outcomes differ considerably from conventional osteosarcoma. In this review, we outline the clinical.
Paget's disease of the breast is a rare form of breast cancer - about 1-4 % of breast cancers. Paget's disease is a cancer involving the nipple and adjacent tissue. Tumors are usually present within the breast tissue as well, although may be difficult to find on mammography alone A review of Paget's disease of bone with a focus on the efficacy and safety of zoledronic acid 5 mg. Curr Med Res Opin. 2008 Mar. 24(3):695-705. [Medline] . Woitge HW, Oberwittler H, Heichel S. Mammary Paget's disease is a rare presentation of breast cancer. At clinical examination, it is characterized by skin lesions of the nipple-areola complex, almost always a sign of malignancy. In fact, it is often associated with an underlying mammary ductal carcinoma in situ (DCIS) or invasive carcinoma. An underlying carcinoma is also common in women with negative mammography and ultrasound. Doctors use blood tests and imaging tests to diagnose Paget's disease. Early diagnosis and treatment can prevent some symptoms from getting worse. Treatments include medicines and sometimes surgery. A good diet and exercise might also help Imaging in Osteoporosis and Paget's disease 1. By- Dr.Sahil Chaudhry Moderator- Dr. Gururaj Sharma AJIMS MANGALORE 2. Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Osteoporosis is characterized by reduced bone mass and disruption of architecture resulting in increased bone fragility and increased.
Objective. Radiologists are often challenged to review CT examinations of the skull without pertinent clinical information or plain radiographs. Skull lesions of fibrous dysplasia (FD) may often be confused with Paget disease (PD). The purpose of this article is to evaluate radiographic similarities and to find the signs that can differentiate PD from FD of the skull on head CT and to describe. Paget disease is a localized disorder of bone remodeling that typically begins with excessive bone resorption followed by an increase in bone formation.  This osteoclastic overactivity followed by compensatory osteoblastic activity leads to a structurally disorganized mosaic of bone (woven bone), which is mechanically weaker, larger, less compact, more vascular, and more susceptible to. Evaluation. Paget's disease of right innominate bone. Skull CT showing cotton wool spots typical of later stages of Paget's disease. Imaging to evaluate for fractures. Initial lesion may be destructive, radiolucent (especially in skull) Involved bones may be expanded, abnormally dense. May have multiple fissure fractures in long bones A physical examination of the affected areas is usually followed by blood tests and imaging tests for the detection of Paget's disease. Imaging Tests (Radiology) X-ray images of the affected bone can indicate abnormalities such as an increase in density, enlargement, and deformity in shape. In the initial stages, a hole appears in the bone. Radiological imaging of Paget's disease. 2. Paget disease (osteitis deformans) is a chronic skeletal disorder characterized by abnormal and excessive remodeling of bone. The disease was named after Sir James Paget who described the condition in 1877 in a detailed essay recognized in the medical literature as a lesson in accurate and lucid.
Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Paget Disease of Nippl Paget disease is a localized disorder of bone remodeling that typically begins with excessive bone resorption followed by an increase in bone formation. This osteoclastic overactivity followed by compensatory osteoblastic activity leads to a structurally disorganized mosaic of bone (woven bone), which is mechanically weaker, larger, less comp.. Paget's Disease of the Vulva is a very rare form of Paget's disease that arises from a location outside the breast (extramammary site). In addition to the vulva, Extramammary Paget's Disease (EMPD) can also arise in the groin (penis and scrotum) and perineum region). The condition may be associated with other malignant tumors
Paget's disease of the breast is characterized by inflammatory, eczema-like changes of the nipple that may extend to involve the areola, which is the circular, darkened (pigmented) region of skin surrounding the nipple. Initial findings often include itching (pruritus), scaling, and crusting of and/or discharge from the nipple Muttarak M, Siriya B, Kongmebhol P, et al. Paget's disease of the breast: clinical, imaging and pathologic findings: a review of 16 patients. Biomed Imaging Interv J 2011; 7:e16. Günhan-Bilgen I, Oktay A. Paget's disease of the breast: clinical, mammographic, sonographic and pathologic findings in 52 cases Paget's disease (PD) is a chronic metabolically active bone disease, characterized by a disturbance in bone modelling and remodelling due to an increase in osteoblastic and osteoclastic activity. The vertebra is the second most commonly affected site. This article reviews the various spinal pathomechanisms and osseous dynamics involved in producing the varied imaging appearances and their. Aug 3, 2014 - The blade of grass sign, also called the candle flame sign, refers to the lucent leading edge in a long bone seen during the lytic phase of Paget disease of bone. The blade of grass sign is characteristic of Paget disease of bone. This is akin t.. Banana fracture - Paget disease | Radiology Case | Radiopaedia.org. The softening of bone that occurs in Paget disease makes it susceptible to insufficiency fracture. A banana fracture is one of these insufficiency fractures. One can tell it is an insufficiency fracture and not a fatigue stress fracture becaus..
Paget's disease of bone. Whitehouse RW(1). Author information: (1)Department of Radiology, Manchester Royal Infirmary, Manchester, United Kingdom. Richard.Whitehouse@cmmc.nhs.uk Paget's disease of bone is one of the most common diseases to affect bone, yet it is rare before the age of 50. The etiology of the condition remains unproven Paget's disease is a disorder of abnormal and excessive bone remodeling, which results in deformed and weakened bones. It is usually asymptomatic, however, it can produce pain. It can lead to secondary osteoarthritis, as seen in the image below. Frontal radiograph of the pelvis shows marked sclerosis of the sacroiliac joints, as well as the. Imaging in Paget Disease of the Skull Four cases of Paget disease of the skull were studied with magnetic resonance (MR) imaging_ With optimal use of projection and technical factors, MR permits simultaneous demonstration of osseous deformity and its relation to the underlying soft tissues
Paget disease of the breast: analysis of 41 patients. Am J Clin Oncol. 2001;24:397-400. 5. Morrogh M, et al. MRI identifies otherwise occult disease in se-lect patients with Paget disease of the nipple. J Am Coll Surg. 2008 Feb;206(2):316-21. 6. Echevarria JJ, et al. Usefulness of MRI in detecting occult breast cancer associated with Paget's. 1. Arch Otolaryngol Head Neck Surg. 2001 Sep;127(9):1137-9. Radiology quiz case. Labyrinthine obliteration due to Paget disease. Nabili V, Buckner AD, Niparko JK Paget's disease of the bone is a common, non-inflammatory, metabolic, skeletal disorder of unknown aetiology characterized by an increase in osteoclast-mediated bone resorption and compensatory excessive osteoblast activation. Prevalence increases with age, and a pronounced geographical variation is well documented. The disease is often an incidental finding on a radiological examination. Sarcoma arising in Paget's disease of bone: declining incidence and increasing age at presentation. Bone 2009; 44 (3) 431-436 ; 33 Tins BJ, Davies AM, Mangham DC. MR imaging of pseudosarcoma in Paget's disease of bone: a report of two cases. Skeletal Radiol 2001; 30 (3) 161-16 The sensitivity of conventional imaging modalities is low when it comes to detecting breast carcinoma associated with Paget's disease. A recent study  reported that the sensitivity of mammography and breast ultrasound was of 79% and 74% respectively for detecting invasive cancer but only of 39% and 19% for DCIS
Diagnostic imaging. Paget disease of the bone is diagnosed radiologically. Early in the course of the disease, lytic activity predominates, causing focal osteolytic lesions (osteoporosis circumscripta) or flame shaped, advancing lytic wedges in the long bones (Figure 1).Subsequently, areas of sclerosis develop, leading to the characteristic appearances of mixed lytic and sclerotic areas. Paget's disease is a relatively common condition in the elderly population and is not uncommonly seen as an incidental finding on imaging studies, including magnetic resonance imaging (MRI). It is important, therefore, for the radiologist to be aware of the MRI manifestations of the condition, so as not to mistake it for more sinister pathology. MRI can also be used to investigate the various. Platybasia: invagination of base of skull due to weak bone, compression of posterior fossa structures. Associated neoplasms: sarcoma (5% with severe polyostotic disease), giant cell tumor, giant cell granuloma. NOT related to Paget disease of breast or vulva, although both discovered by Sir James Paget, one of the founders of pathology
D. HER2: the majority of Paget disease cases are HER2 positive and therefore HER2 can be used to confirm the diagnosis. In the absence of invasive carcinoma, HER2 positivity does not influence treatment since Paget disease is an in situ carcinoma. Paget disease is negative for CK5 / 6 and CK20. ER and PR show variable expression. Comment Her Paget disease (PD) is a chronic disorder resulting in enlarged and misshapen bones, caused by disorganized bone remodeling. This case involves a 64-year-old man with prostatic adenocarcinoma and PD of some skeletal areas with increased uptake shown on 18 F-fluoro-methyl-choline (FMC) positron emission tomography/ computed tomography (PET/CT) performed for cancer restaging Radiology Teaching Files Our radiology teaching file system contains hundreds of interesting cases available for review. The system is intended to provide practice to physicians, fellows and residents in the interpreptation of radiological images from a variety of different cases Paget disease of the breast is a rare type of breast cancer involving the skin of the nipple and the areola (the dark circle around the nipple). Paget disease usually affects only one breast. In 80-90% of cases, it's usually found along with either ductal carcinoma in situ (DCIS) or infiltrating ductal carcinoma (invasive breast cancer)