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The HKU E-learning Platform in Clinical Medicine
The HKU E-learning Platform in Clinical Medicine
  • Physical Examination Skills
    • General Examination
    • Examination of the Cardiovascular System
    • Examination of the Gastrointestinal System
    • Examination of the Neurological System
    • Examination of the Respiratory System
    • Examination of the Musculoskeletal System
    • Demonstration on putting on a surgical/ N95 mask properly
  • eLearning Materials of Individual Divisions
    • Cardiology
    • Clinical Pharmacology
    • Dermatology
    • Endocrinology
    • Gastroenterology & Hepatology
    • Geriatrics
      • Common Physical Signs in the Geriatric Setting
      • Commonly used Assessments in the Geriatric Setting
    • Haematology
    • Infectious Diseases
    • Nephrology
      • General Nephrology
      • Imaging
      • Peritoneal Dialysis
      • Hemodialysis
    • Neurology
    • Rehabilitation Medicine
      • Modified Ashworth Scale
      • Complex Regional Pain Syndrome
      • Case 1
      • Case 2
    • Respiratory Medicine
    • Rheumatology
      • Common Rheumatological Cases
      • Clinical Signs and Radiographs of Patients with Rheumatological Disorders
  • Credits
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Endocrinology

Paget’s Disease of the Bone

December 8th, 2014

Paget’s Disease of the Bone

An elderly woman presented with isolated raised serum alkaline phosphotase level. On examination, she was noted to have the following features:

  • Enlarged skull with frontal bossing
  • Anterior bowing of legs

Other significant findings

  • Hearing aid
  • Kyphosis secondary to osteoporotic vertebral collapse

Workup

  • Skeletal survey
  • Skull X-Ray showing thickening of skull vault and cotton wool areas of sclerotic bone in keeping with Paget’s disease
  • Pure tone audiometry
  • Echocardiogram

Pagets’ Spine
Paget’s Femur
Pagets’ Skull

Diagnosis

  • Bone scan

Management

  • Monitoring of symptoms of complications of Paget’s disease, including bone pain, heart failure and hearing impairment
  • Monitoring of serum ALP level
  • Bisphosphonates if necessary

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