Radiographic, computed tomographic and magnetic resonance imaging appearances of primary V-cutting zone of resorption of lumbar vertebral body in Paget's disease

Abstract

Background. Paget's disease of bone typically demonstrates three evolutionary phases with the characteristic radiographic findings. The incipient stage is manifested by an advancing lytic zone of resorption. Unlike the skull and the long bones the primary advancing zone of rarefication has not been clearly demonstrated within the spine and pelvis. Case report. A 62-year-old man with histologically proved polyostotic Paget's disease was admitted to the hospitaldue to the exacerbation of pain at the toracolumbar junction with deterioration during the night. Due to slight elevation of acid phosphatase and clinical signs indicating prostatic hypertrophy the possibility of metastatic prostatic carcinoma has been raised. A bone scintigraphy with technetium phosphonate showed the expected marked increased uptake affecting numerous bones with the typical radiographic signs of Paget's disease. Besidesthese findings, there was also moderate focal accumulation within the right dorsal half of the vertebral body of L1. Conventional tomography, computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated theprimary cutting zone of resorption affecting the same region. Conclusions. We present a unique case of Paget's disease with primary V-cutting zone withinthe undeformed vertebral body of L1 and spontaneous progression to the midphase of the disease on a three year follow-up.

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Data

Language:	English
Year of publishing:	2004
Typology:	1.04 - Professional Article
Organization:	OI - Institute of Oncology
Publisher:	Association of Radiology and Oncology
UDC:	616-07
COBISS:	19027161
ISSN:	1318-2099
Views:	28
Downloads:	5
Average score:	0 (0 votes)
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Other data

Secondary language:	Slovenian
Secondary title:	Radiografski, računalniškotomografski in magnetnoresonančni znaki primarne cone kostne resorpcije v korpusu ledvenega vretenca pri Pagetovi bolezni
Secondary abstract:	Izhodišča. Potek Pagetove bolezni kosti ima tri razvojne faze z značilnimi radiografskimi znaki. V začetni fazi je prisotna napredujoča cona kostne resorpcije. Primarna napredujoča cona osteolize ni bila nikoli jasno prikazanana hrbtenici in medenici, kot je bila na lobanji in dolgih kosteh. Prikaz primera. 62-letni bolnik s histološko potrjeno diagnozo poliostotske Pagetove bolezni je bil sprejet v bolnico zaradi bolečin v višini torakolumbalnega prehoda, ki so se ponoči stopnjevale. Zaradi zmerno zvišane kisle fosfataze ter kliničnih znakov hipertrofije prostate je bil postavljen sum na karcinom prostate. Kostna scintigrafija s tehnecijevim fosfonatom je pokazala pričakovano nabiranje radiofarmaka na številnih kostnih elementih s tipičnimi radiografskimi znaki Pagetove bolezni. Razen omenjenega se je pokazalo zmerno žariščno nabiranje radiofarmaka tudi v desni dorzalni polovicikorpusa vretenca L1. V istem področju so klasična tomografija, računalniška tomografija (CT) ter magnetnoresonančna tomografija (MRI) prikazale primarno cono kostne resorpcije. Zaključki. Prikazan je edinstven primer Pagetove bolezni s primarno cono kostne resorpcije v morfološko nespremenjenem korpusu vretenca L1. Po treh letih zasledovanja je prišlo do spontanega napredovanja v srednjo fazo bolezni.
Secondary keywords:	Osteitis Deformans;Spondylolysis;Tomography, X-Ray Computed;Magnetic Resonance Imaging;Middle Age;Magnetna resonanca slikovna;Osteitis deformans;Spondiloliza;Tomografija radiografska, računalniška;Srednja leta;
Source comment:	BSDOCID112283;
Pages:	str. 333-338
Volume:	ǂLetn. ǂ38
Issue:	ǂšt. ǂ4
Chronology:	2004
ID:	22902991