Paget Disease Differential Diagnoses

Updated: Sep 12, 2022
  • Author: Mujahed M Alikhan, MD; Chief Editor: Herbert S Diamond, MD  more...
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Diagnostic Considerations

The differential diagnosis of Paget disease includes osteomalacia, which may be part of the spectrum of osseous abnormalities accompanying chronic renal insufficiency. Patients with mild osteomalacia may present with nonspecific bone pain and tenderness. Elevated levels of bone-specific alkaline phosphatase may occur in osteomalacia or in Paget disease.

Both disorders may result in fractures. However, in Paget disease, distinctive horizontal radiolucencies are visible on the convex surface of the bone, whereas in osteomalacia they are visible on the concave aspects of the bone.

Both Paget disease and skeletal metastasis can produce bone pain and radiographically similar lytic lesions. Diagnostic confirmation may require biopsy. [4]

Differential Diagnoses