CT images of the skull Differential diagnosis Paget

CT images of the skull Differential diagnosis: Paget disease and aneurysmal bone cyst Nikolett Marton MD Trainee in radiology: Jahn Ferenc Hospital, Budapest, Hungary Ph. D student: Semmelweis University, Budapest, Hungary EULAR Imaging Course, 30 March- 1 April, Lisbon

N Marton Budapest, Hungary CT images Acute non-contrast-enhanced computed tomography of the skull Transverse (axial) plane, Bone window Elderly patient with the possibility of acute intracranial hemorrhage Paget or not Paget? EULAR Imaging Course, 30 March- 1 April, Lisbon Radiopaedia. com

N Marton Budapest, Hungary CT images 2 short case reports which helped to decide about the diagnosis: (both >70 yrs old patients, examined to exclude the possibility of acute cerebral hemorrhage) EULAR Imaging Course, 30 March- 1 April, Lisbon

N Marton Budapest, Hungary CT images Acute non-contrast-enhanced computed tomography of the skull Transverse (axial) plane, Bone window 80 yo female Cause of examination: intracranial hemorrhage? Incidental finding: Paget disease of the skull EULAR Imaging Course, 30 March- 1 April, Lisbon Radiopaedia. com

N Marton Budapest, Hungary CT images Paget disease of the skull: Osteoporosis circumscripta: large, well-defined lytic lesion Radiopaedia. com EULAR Imaging Course, 30 March- 1 April, Lisbon

N Marton Budapest, Hungary CTimages Paget disease of the skull: cotton wool appearance: mixed lytic and sclerotic lesions of the skull Radiopaedia. com EULAR Imaging Course, 30 March- 1 April, Lisbon

N Marton Budapest, Hungary CT images Paget disease of the skull: diploic widening: both inner and outer calvarial tables are involved, with the former usually more extensively affected Radiopaedia. com EULAR Imaging Course, 30 March- 1 April, Lisbon

N Marton Budapest, Hungary CT images Paget disease of the skull: Tam o'Shanter sign: frontal bone enlargement, with the appearance of the skull falling over the facial bones, like a Tam o' Shanter hat Radiopaedia. com EULAR Imaging Course, 30 March- 1 April, Lisbon

N Marton Budapest, Hungary CT images Acute non-contrast-enhanced computed tomography of the skull Transverse (axial) plane, Bone window 80 yo female Cause of examination: intracranial hemorrhage? Aneurysmal bone cyst of the skull EULAR Imaging Course, 30 March- 1 April, Lisbon Mediworld Plus Kft. Hungary

N Marton Budapest, Hungary CT images Aneurysmal bone cyst: Sharply defined, expansile osteolytic lesions, with thin sclerotic margins. No cotton wool sign! No general diploic widening! Benign expansile tumour-like bone lesions of uncertain aetiology, composed of numerous blood filled channels, and mostly diagnosed in children and adolescents. Epidemiology: they are primarily seen in children and adolescents –> Not an incidental finding on mature patients’ skull CT. Radiopaedia. com EULAR Imaging Course, 30 March- 1 April, Lisbon

N Marton Budapest, Hungary CT images Acute non-contrast-enhanced computed tomography of the skull Transverse (axial) plane, Bone window 70 yo male Cause of examination: intracranial hemorrhage? Aneurysmal bone cyst of the skull EULAR Imaging Course, 30 March- 1 April, Lisbon Radiopaedia. com

N Marton Budapest, Hungary CT images Thank you for your kind attention! Egill Skallagrímsson: The famous viking warrior suffered from Paget disease Headstuff. org EULAR Imaging Course, 30 March- 1 April, Lisbon