My colleague consulted with me on this 58F with "funny looking bones"
For years, all of her bones look like this, and have been reported as "Paget disease" or suggestive of Paget disease….seemingly missing the point that Paget can affect any and many, but not Every bone.
Channeling a long deceased mentor, I told my colleague to call the referrer, who must know the patient’s diagnosis.
But they have apparently been believing our reports of Paget through the years.
I had wondered about underlying renal disease….and while we have no labs, the CT of the Chest/Abd in Feb show normal sized kidneys without nephrocalcinosis
This shoulder MRI from today shows pretty much normal marrow signal (this is the only T1 weighted sequence), though the cortices are diffusely thickened
Clearly this should be a systemic process….possibly metabolic or congenital.
As it mimics Paget I think of "Juvenile" Paget….though she is an adult….could this be an adult with Hyperphosphotasia?
What do you think this is?
Are there any other imaging or lab tests to recommend, or just a metabolic bone consult?
Hilary
