On imaging, the bone is typically thickened with a variable amount of lytic and sclerotic change. The T1 signal of the involved marrow is diminished secondary to replacement of marrow fat by fibrous tissue. There may be enhancement due to the increased vascularity of the Pagetic bone.
The etiology for the dural thickening and enhancement here is probably due to inflammation from adjacent Pagetic bone. The changes are most apparent where the frontal bones are most involved. This patient has no other reason for the dural findings. Other entities which may be considered in the differential for Pagets disease include osteopetrosis, fibrous dysplasia, and metastases. Fibrous dysplasia and osteopetrosis present in younger patients. In addition, osteopetrosis produces a more confluent, avascular thickening of bone. A metastatic lesion may mimic a focal area of Paget's disease. Related Cases
|Craniometaphyseal dysplasia||Fibrous dysplasia||Renal cell carcinoma|