Advanced Paget disease of bone

Kay Hau Choy and Sumaya Alukaidey
Med J Aust 2017; 207 (4): . || doi: 10.5694/mja17.00303
Published online: 21 August 2017

A 77-year-old woman presented with longstanding left leg weakness and falls. A computed tomography scan displayed a marked widening of the diploic space of the calvaria with lytic and sclerotic regions (Figure, A and B), which is pathognomonic of advanced Paget disease affecting the skull.1,2 Her leg weakness leading to the falls was due to the expansion of the C2 vertebra, causing stenosis of the cervical spinal canal (Figure, C, arrow). The serum alkaline phosphatase level was 655 U/L (reference range, 20–175 U/L). She received zoledronic acid, resulting in normalisation of serum alkaline phosphatase levels after 12 months; however, her leg weakness did not improve.

  • University Hospital Geelong, Geelong, VIC

Competing interests:

No relevant disclosures.

  • 1. Mirra JM, Brien EW, Tehranzadeh J. Paget’s disease of bone: review with emphasis on radiologic features, part II. Skeletal Radiol 1995; 24: 173-184.
  • 2. Cushing FR, Bone HG. Radiographic diagnosis and laboratory evaluation of Paget’s disease of bone. Clin Rev Bone Miner Metab 2002; 1: 115-134.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.