title: [A woman with a growing skull].
abstract: In a 79-year-old female, a markedly elevated alkaline phosphatase level was found by chance. She had noticed her hats had become too small. Clinical examination revealed a large skull with frontal bossing. Bone scintigraphy showed increased activity of bone metabolism in the skull. These three findings combined are considered a classic example of Paget's disease.
authors.affiliation: Medisch Centrum Alkmaar, afd. Interne Geneeskunde, Alkmaar, the Netherlands. c.r.van.rooijen@mca.nl
authors.forename: Cleo R
authors.initials: CR
authors.lastname: van Rooijen
authors.forename: Suat
authors.initials: S
authors.lastname: Simsek
authors.forename: Frank
authors.initials: F
authors.lastname: Stam
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood*; D005260:Female; D006801:Humans; D010001:Osteitis Deformans / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D012886:Skull / Q000000981:diagnostic imaging
chemical_list: D000469:Alkaline Phosphatase