Chapter 72: Paget’s Disease of Bone Ethel S. Siris and G. David Roodman

From the Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 7th Edition. www.asbmrprimer.org Figure 1 Figure 1 Scanning electron micrographs with sections of normal bone (left) and pagetic bone (right). Both samples were taken from the iliac crest. The normal bone shows the trabecular plates and marrow spaces to be well preserved, whereas the pagetic bone has completely lost this architectural appearance. Extensive pitting of the pagetic bone is apparent caused by dramatically increased osteoclastic bone resorption. [Photographs courtesy of Dr. David Dempster; reproduced with permission from Lippincott from Siris ES, Canfield RE 1995 Paget’s disease of bone. In: Becker KL (ed.) Principles and Practice of Endocrinology and Metabolism, 2nd ed. JB Lippincott, Philadelphia, PA, USA, pp. 585–594 (http://lww.com).] Figure 1 Scanning electron micrographs with sections of normal bone (left) and pagetic bone (right). Both samples were taken from the iliac crest. The normal bone shows the trabecular plates and marrow spaces to be well preserved, whereas the pagetic bone has completely lost this architectural appearance. Extensive pitting of the pagetic bone is apparent caused by dramatically increased osteoclastic bone resorption. [Photographs courtesy of Dr. David Dempster; reproduced with permission from Lippincott from Siris ES, Canfield RE 1995 Paget’s disease of bone. In: Becker KL (ed.) Principles and Practice of Endocrinology and Metabolism, 2nd ed. JB Lippincott, Philadelphia, PA, USA, pp. 585–594 (http://lww.com).]

From the Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 7th Edition. www.asbmrprimer.org Figure 2 Figure 2 Radiograph of a humerus showing typical pagetic change in the distal half, with cortical thickening, expansion, and mixed areas of lucency and sclerosis, contrasted with normal bone in the proximal half. Figure 2 Radiograph of a humerus showing typical pagetic change in the distal half, with cortical thickening, expansion, and mixed areas of lucency and sclerosis, contrasted with normal bone in the proximal half. © 2008 American Society for Bone and Mineral Research

From the Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 7th Edition. www.asbmrprimer.org Figure 3 Figure 3 Typical “cotton-wool” appearance of an enlarged pagetic skull with marked osteoblastic change. The patient had an increase in head size and deafness. Figure 3 Typical “cotton-wool” appearance of an enlarged pagetic skull with marked osteoblastic change. The patient had an increase in head size and deafness. © 2008 American Society for Bone and Mineral Research