In which condition would you expect to see bone expansion and cortical thickening on X-ray?

In which condition would you expect to see bone expansion and cortical thickening on X-ray?

• A. Osteosarcoma
• B. Paget's disease
• C. Chondrosarcoma
• D. Osteomyelitis

Answer: (B)

Bone expansion and cortical thickening on X-ray are characteristic features of Paget's disease. This condition is marked by abnormal bone remodeling, leading to the excessive breakdown of bone followed by disorganized new bone formation. As a result, patients may exhibit enlarged bones with increased density due to the thickened trabecular structure and cortical surfaces. In Paget's disease, these changes can result in localized areas of osteolysis along with areas of new, disorganized bone formation, leading to the classic appearance seen on imaging studies. This can manifest as enlarged bones, particularly in the pelvis, skull, and long bones. The other conditions listed do not exhibit these specific radiographic features. For instance, osteosarcoma, while it may cause bone destruction, typically does not present with thickening and expansion but rather with aggressive bone lesions. Chondrosarcoma often demonstrates a permeative pattern of bone destruction and may have variable appearances depending on its grade, but it does not commonly cause diffuse cortical thickening. Osteomyelitis usually leads to bone destruction as well, often with the presence of an associated infection, and does not typically show the bone expansion and thickening noted in Paget's disease.

Bone expansion and cortical thickening on X-ray are characteristic features of Paget's disease. This condition is marked by abnormal bone remodeling, leading to the excessive breakdown of bone followed by disorganized new bone formation. As a result, patients may exhibit enlarged bones with increased density due to the thickened trabecular structure and cortical surfaces.

In Paget's disease, these changes can result in localized areas of osteolysis along with areas of new, disorganized bone formation, leading to the classic appearance seen on imaging studies. This can manifest as enlarged bones, particularly in the pelvis, skull, and long bones.

The other conditions listed do not exhibit these specific radiographic features. For instance, osteosarcoma, while it may cause bone destruction, typically does not present with thickening and expansion but rather with aggressive bone lesions. Chondrosarcoma often demonstrates a permeative pattern of bone destruction and may have variable appearances depending on its grade, but it does not commonly cause diffuse cortical thickening. Osteomyelitis usually leads to bone destruction as well, often with the presence of an associated infection, and does not typically show the bone expansion and thickening noted in Paget's disease.