Which radiographic finding is NOT typical of Paget disease?

Which radiographic finding is NOT typical of Paget disease?

• A. Cotton-wool skull appearance
• B. Ground-glass pattern
• C. Cotton-wool skull appearance
• D. Thickened, disorganized bone

Answer: (B)

Paget disease thickens and disorganizes bone, producing a mosaic pattern of sclerosis. In the skull, this shows up as patchy, fluffy areas known as the cotton-wool appearance. A ground-glass pattern, by contrast, is not typical for Paget disease; that hazy, diffuse radiopacity is more characteristic of fibrous dysplasia, where fibrous tissue replaces normal bone and creates a less patchy, more uniform ground-glass look. So the finding that doesn’t fit Paget disease is the ground-glass pattern.

Paget disease thickens and disorganizes bone, producing a mosaic pattern of sclerosis. In the skull, this shows up as patchy, fluffy areas known as the cotton-wool appearance. A ground-glass pattern, by contrast, is not typical for Paget disease; that hazy, diffuse radiopacity is more characteristic of fibrous dysplasia, where fibrous tissue replaces normal bone and creates a less patchy, more uniform ground-glass look. So the finding that doesn’t fit Paget disease is the ground-glass pattern.