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Radiology, Vol 209, 641-651, Copyright © 1998 by Radiological Society of North America

ARTICLES

Complications in Paget disease at MR imaging

RD Boutin, DJ Spitz, JS Newman, L Lenchik and LS Steinbach
Department of Radiology, University of California, San Diego School of Medicine, USA.

PURPOSE: To determine the MR imaging findings in patients with complications of Paget disease of bone. MATERIALS AND METHODS: Of 45 patients with Paget disease who underwent MR imaging, 33 (26 men, seven women; age range, 64-91 years) with known complications of the disease were examined. Imaging in this subgroup included radiography (n = 26), computed tomography (n = 12), bone scintigraphy (n = 15), and magnetic resonance (MR) imaging (n = 33). Patients were examined specifically for musculoskeletal and neurologic complications of Paget disease, including fracture, basilar impression, spinal stenosis, bone tumor, and osteoarthrosis. RESULTS: The 56 complications documented in the 33 patients were fracture (n = 17), neurologic entrapment (n = 19), neoplasm (n = 9), and arthropathy (n = 11). MR imaging was beneficial in the diagnostic evaluation of basilar impression (n = 7), spinal stenosis (n = 12), and the tumor stage (n = 9). It also helped to successfully evaluate pagetic bone narrowing of the coracoacromial arch, which was associated with impingement syndrome and rotator cuff rupture (n = 2). The signal intensities in pagetic bone were most commonly similar to those in fat; this finding had a 100% negative predictive value in excluding neoplasm. CONCLUSION: Although Paget disease is diagnosed economically with conventional radiography, MR imaging is well suited for demonstrating the presence and extent of several characteristic disease complications, including basilar impression, spinal stenosis, and secondary neoplasm.


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S. E. Smith, M. D. Murphey, K. Motamedi, M. E. Mulligan, C. S. Resnik, and F. H. Gannon
From the Archives of the AFIP: Radiologic Spectrum of Paget Disease of Bone and Its Complications with Pathologic Correlation
RadioGraphics, September 1, 2002; 22(5): 1191 - 1216.
[Abstract] [Full Text] [PDF]


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