Atypical vertebral Paget's disease

Skeletal Radiol. 2014 Jul;43(7):991-5. doi: 10.1007/s00256-013-1799-9. Epub 2014 Jan 22.

Abstract

A 40-year-old Mauritanian man consulted for back pain. A computed tomography of the spine showed patchy sclerosis of the fifth and seventh thoracic vertebral bodies with normal neural arch of T5 and sclerosis and hypertrophy of the neural arch of T7, as well as diffuse sclerosis of the T11 vertebral body with a normal neural arch. At MRI, low signal-intensity on T1-weighted images and high signal-intensity on T2-weighted images involved the whole T5 and T7 vertebrae and the vertebral body of T11. Working diagnoses included metastatic disease and lymphoma, and a biopsy of T7 and then T11 was carried out. Both showed pathological findings very suggestive of Paget's disease. Since CT is usually the more specific radiological examination in vertebral Paget's disease, we thought it could be useful to report this atypical CT presentation (patchy sclerosis of the vertebral body without diffuse bone texture changes and isolated involvement of the vertebral body) of vertebral Paget's disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Humans
  • Male
  • Osteitis Deformans / diagnostic imaging*
  • Sclerosis / diagnostic imaging
  • Sclerosis / pathology
  • Spinal Diseases / diagnostic imaging
  • Spinal Diseases / pathology*
  • Thoracic Vertebrae / diagnostic imaging*
  • Thoracic Vertebrae / pathology*
  • Tomography, X-Ray Computed / methods*