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.
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References
Altman RD. Musculoskeletal manifestations of Paget’s disease of bone. Arthritis Rheum. 1980;23(10):1121–7.
Resnick D. Diagnosis of bone and joint disorders. Philadelphia: Saunders; 1995.
Pestka JM, Seitz S, Zustin J, Puschel K, Amling M, Barvencik F. Paget disease of the spine: an evaluation of 101 patients with a histomorphometric analysis of 29 cases. Eur Spine J. 2012;21(5):999–1006.
Maldague B, Malghem J. Radiological aspects of Paget’s disease of bone (author’s transl). J Belge Rhumatol Med Phys. 1974;29(5–6):293–321.
Zlatkin MB, Lander PH, Hadjipavlou AG, Levine JS. Paget disease of the spine: CT with clinical correlation. Radiology. 1986;160(1):155–9.
Dell’Atti C, Cassar-Pullicino VN, Lalam RK, Tins BJ, Tyrrell PN. The spine in Paget’s disease. Skeletal Radiol. 2007;36(7):609–26.
Dohan A, Parlier-Cuau C, Bourillon C, Petrover D, Bousson V, Chicheportiche V, et al. Vertebral involvement in Paget’s disease: CT and MR appearances of a mad bone. Chicago: Radiological Society of North America. 2011.
Chretien J. Vertebral localizations of Paget disease. Ann Radiol (Paris). 1995;38(4):169–76.
Vande Berg BC, Malghem J, Lecouvet FE, Maldague B. Magnetic resonance appearance of uncomplicated Paget’s disease of bone. Semin Musculoskelet Radiol. 2001;5(1):69–77.
Godefroy D, Chevrot A, Ranoux C, Horreard P, Moutounet J, Pallardy G. The posterior arch of the Paget’s ivory vertebra. Biopsy of six cases (author’s transl). J Radiol. 1980;61(10):611–4.
Maldague B, Malghem J. Radiological aspects of Paget’s disease of bone (author’s transl). Acta Orthop Belg. 1974;40(4):425–53.
Smith SE, Murphey MD, Motamedi K, Mulligan ME, Resnik CS, Gannon FH. From the archives of the AFIP. Radiologic spectrum of Paget disease of bone and its complications with pathologic correlation. Radiographics. 2002;22(5):1191–216.
Sprecher S, Steinberg R, Lichtenstein D, Witt KM, Barginear M. Magnetic resonance imaging presentation of lytic Paget’s disease of the cervical spine. J Bone Miner Res. 2002;17(11):1929–30.
Steinbach LS, Johnston JO. Case report 777. Osteolytic Paget’s disease of the fifth lumbar vertebra. Skeletal Radiol. 1993;22(3):203–5.
Rosen MA, Wesolowski DP, Herkowitz HN. Osteolytic monostotic Paget’s disease of the axis. A case report. Spine. 1988;13:125–7.
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Beaudouin, C., Dohan, A., Nasrallah, T. et al. Atypical vertebral Paget’s disease. Skeletal Radiol 43, 991–995 (2014). https://doi.org/10.1007/s00256-013-1799-9
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DOI: https://doi.org/10.1007/s00256-013-1799-9