Pathological fracture of the femur in a patient with Paget's disease of bone: a case report

Paget's disease of bone is a benign disease characterized by exaggerated remodeling of the bone matrix after osteoclast-mediated bone destruction. Its etiology is still unknown, despite the fact that it was discovered and described in 1877, but genetic factors and environmental triggers were sh...

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Veröffentlicht in:Romanian journal of morphology and embryology 2016, Vol.57 (2), p.595-600
Hauptverfasser: Petrescu, Pompiliu HoraŢiu, Izvernariu, Dragoş Andrei, Iancu, Cătălina, Dinu, Gabriel Ovidiu, Berceanu-Văduva, Marcel Mihai, Crişan, Dan, Iacob, Mihaela, Bucur, Venera Margareta, RăuŢia, Ion Călin, Prejbeanu, Ion Radu, Dema, Sorin, DuŢă, Ciprian Constantin
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container_issue 2
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container_title Romanian journal of morphology and embryology
container_volume 57
creator Petrescu, Pompiliu HoraŢiu
Izvernariu, Dragoş Andrei
Iancu, Cătălina
Dinu, Gabriel Ovidiu
Berceanu-Văduva, Marcel Mihai
Crişan, Dan
Iacob, Mihaela
Bucur, Venera Margareta
RăuŢia, Ion Călin
Prejbeanu, Ion Radu
Dema, Sorin
DuŢă, Ciprian Constantin
description Paget's disease of bone is a benign disease characterized by exaggerated remodeling of the bone matrix after osteoclast-mediated bone destruction. Its etiology is still unknown, despite the fact that it was discovered and described in 1877, but genetic factors and environmental triggers were shown to play their part in the pathogenesis of the disease. The main clinical presentations of the disease are related to bone pain and deformities. Radiological diagnosis is the main detection tool, though many monostotic Paget's disease cases may remain undiagnosed. We present the case of an 81-year-old male patient admitted to the Clinic of Orthopedics, Emergency County Hospital, Timisoara, Romania, with intense pain and deformity of the upper left thigh. Radiological examination performed shows a complete fracture of the upper third diaphysis of the left femur with suggestive signs for Paget's disease of the bone therefore a biopsy was taken and the patient was treated by surgical realignment with favorable evolution. He was discharged 13 days after surgery. The biopsy of the bone revealed extensive bone remodeling with numerous osteoclasts and extensive bone matrix deposition, unevenly stained and unevenly mineralized and reverse cement lines, which are consistent with the diagnosis of Paget's disease of the bone. Histomorphometric analysis show intense matrix deposition with a highly active remodeling process. Computed tomography (CT) scans were performed three years later and show the extension of the disease into the lower half of the left femur.
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source MEDLINE; EZB-FREE-00999 freely available EZB journals
subjects Aged, 80 and over
Femoral Fractures - complications
Femoral Fractures - diagnostic imaging
Femoral Fractures - pathology
Femur - pathology
Humans
Male
Osteitis Deformans - complications
Osteitis Deformans - diagnostic imaging
Osteitis Deformans - pathology
Osteoclasts - pathology
Radiographic Image Interpretation, Computer-Assisted
Tomography, X-Ray Computed
title Pathological fracture of the femur in a patient with Paget's disease of bone: a case report
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