title: Pathological fracture of the femur in a patient with Paget's disease of bone: a case report.
abstract: 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.
authors: Department of Orthopedics and Trauma, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania; lalusha87@yahoo.com.
authors: Pompiliu HoraŢiu
authors: PH
authors: Petrescu
authors: Dragoş Andrei
authors: DA
authors: Izvernariu
authors: Cătălina
authors: C
authors: Iancu
authors: Gabriel Ovidiu
authors: GO
authors: Dinu
authors: Marcel Mihai
authors: MM
authors: Berceanu-Văduva
authors: Dan
authors: D
authors: Crişan
authors: Mihaela
authors: M
authors: Iacob
authors: Venera Margareta
authors: VM
authors: Bucur
authors: Ion Călin
authors: IC
authors: RăuŢia
authors: Ion Radu
authors: IR
authors: Prejbeanu
authors: Sorin
authors: S
authors: Dema
authors: Ciprian Constantin
authors: CC
authors: DuŢă
mesh_terms: D000369:Aged, 80 and over; D005264:Femoral Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D005269:Femur / Q000473:pathology; D006801:Humans; D008297:Male; D010001:Osteitis Deformans / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D010010:Osteoclasts / Q000473:pathology; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed