Paget’s Disease of Bone

This case report describes an 80 year old woman with a history of progressive forehead enlargement and hearing loss, initially noted as incidental skull thickening 16 years prior. Imaging revealed characteristic features of Paget’s disease of bone, including cortical thickening, sclerosis, and a "cotton wool" appearance on radiographs. Laboratory tests showed elevated alkaline phosphatase levels, and a bone scan confirmed increased uptake in the skull and pelvis. The patient was diagnosed with Paget’s disease and treated with bisphosphonates, which reduced alkaline phosphatase levels but did not reverse structural changes or hearing loss. The case underscores the importance of early follow-up for incidental radiographic findings and the chronic nature of Paget’s disease.

This case report describes an 80 year old woman with a history of progressive forehead enlargement and hearing loss, initially noted as incidental skull thickening 16 years prior. Imaging revealed characteristic features of Paget’s disease of bone, including cortical thickening, sclerosis, and a "cotton wool" appearance on radiographs. Laboratory tests showed elevated alkaline phosphatase levels, and a bone scan confirmed increased uptake in the skull and pelvis. The patient was diagnosed with Paget’s disease and treated with bisphosphonates, which reduced alkaline phosphatase levels but did not reverse structural changes or hearing loss. The case underscores the importance of early follow-up for incidental radiographic findings and the chronic nature of Paget’s disease.