Age / Sex : 71 / M

Chief complaint : Left knee and calf pain

What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy : 홍성환, Sung Hwan Hong, 서울대학교병원, Seoul National University Hospital

Paget’s disease of the left femur, patellar, and tibia

Discussion

Findings

- Irregular cortical thickening, hypertrophied and coarse trabeculae, and osseous widening at the tibia and patella

- Blade of grass or candle flame sign at the distal femur

- Predominantly fatty marrow with areas of bone marrow T2 hyperintensity on MR imaging

1. Smith S, Murphey M, Motamedi K, Mulligan M, Resnik C, Gannon F. From the Archives of the AFIP. Radiologic Spectrum of Paget Disease of Bone and Its Complications with Pathologic Correlation. Radiographics 2002;22:1191-216


2. 2. Theodorou D, Theodorou S, Kakitsubata Imaging of Paget Disease of Bone and Its Musculoskeletal Complications: Review. AJR Am J Roentgenol 2011;196(6 Suppl):S64-75