COMPLICATIONS IN PAGET-DISEASE AT MR-IMAGING

PURPOSE: To determine the MR imaging findings in patients with complic ations of Paget disease of bone. MATERIALS AND METHODS: Of 45 patients with Paget disease who underwent MR imaging, 33 (26 men, seven women; age range, 64-91 years) with known complications of the disease were examined. Imaging in this subgroup included radiography (n = 26), comp uted tomography (n = 12), bone scintigraphy (n = 15), and magnetic res onance (MR) imaging (n = 33). Patients were examined specifically for musculoskeletal and neurologic complications of Paget disease, includi ng fracture, basilar impression, spinal stenosis, bone tumor, and oste oarthrosis, RESULTS: The 56 complications documented in the 33 patient s were fracture (n = 17), neurologic entrapment (n = 19), neoplasm (n = 9), and arthropathy (n = 11). MR imaging was beneficial in the diagn ostic evaluation of basilar impression (n = 7), spinal stenosis (n = 1 2), and the tumor stage (n = 9). It also helped to successfully evalua te pagetic bone narrowing of the coracoacromial arch, which was associ ated with impingement syndrome and rotator cuff rupture (n = 2). The s ignal intensities in pagetic bone were most commonly similar to those in fat; this finding had a 100% negative predictive value in excluding neoplasm. CONCLUSION: Although Paget disease is diagnosed economicall y with conventional radiography, MR imaging is well suited for demonst rating the presence and extent of several characteristic disease compl ications, including basilar impression, spinal stenosis, and secondary neoplasm.