Endgames
Spot Diagnosis
Plain radiography of the skull after investigation for raised calcium
BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2759 (Published 19 May 2016) Cite this as: BMJ 2016;353:i2759
- David C Howlett, consultant radiologist and honorary clinical professor1,
- Joseph Dalby Sinnott, foundation year 2 doctor2
- 1Department of Radiology, East Sussex Hospitals NHS Trust, Eastbourne, UK
- 2East Sussex Hospitals NHS Trust
- Correspondence to: david.howlett{at}nhs.net
A 63 year old man was being investigated for raised serum calcium and alkaline phosphatase. Plain radiography of the head was performed after a bone scan showed increased uptake in the patient’s skull. What does the radiograph show (fig 1)?
Fig 1
Answer
The radiographic findings are consistent with a diagnosis of Paget’s disease of the bone.
Discussion
The lateral skull radiograph shows marked calvarial thickening, with …
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