Answer:
Pagets Disease of Skull and Temporal Bone.
Findings:
Skull:
Disturbance of the trabecular architecture due to diffuse demineralisation of the diploe with corticomedullary dedifferentiation.
Temporal Bone:
Demineralisation of the otic capsule bilaterally.
Discussion:
The patient had left sensorineural deafness, for which he was referred for MRI. He also had markedly elevated serum alkaline phosphatase. Extensive lytic changes are seen in the calvarium and the skull base. Also note the symmetric demineralisation of otic capsule. The sensoineural deafness may be due to toxic effect on membranous capsule, similar to that occurring in otosclerosis.
Rest of images of the same case are seen below which show typical feature of Pagets of Skull.
Pagets Disease of Skull and Temporal Bone.
Findings:
Skull:
Disturbance of the trabecular architecture due to diffuse demineralisation of the diploe with corticomedullary dedifferentiation.
Temporal Bone:
Demineralisation of the otic capsule bilaterally.
Discussion:
The patient had left sensorineural deafness, for which he was referred for MRI. He also had markedly elevated serum alkaline phosphatase. Extensive lytic changes are seen in the calvarium and the skull base. Also note the symmetric demineralisation of otic capsule. The sensoineural deafness may be due to toxic effect on membranous capsule, similar to that occurring in otosclerosis.
Rest of images of the same case are seen below which show typical feature of Pagets of Skull.
Contributed By: Dr.Iyappan Ponnuswamy MD, FRCR, Consultant Radiologist, Kamakshi Memorial Hospital