Avtor/Urednik		Jevtič, Vladimir
Naslov		Radiographic, computed tomographic and magnetic resonance imaging appearances of primary V-cutting zone of resorption of lumbar vertebral body in Paget's disease
Prevedeni naslov		Radiografski, računalniškotomografski in magnetnoresonančni znaki primarne cone kostne resorpcije v korpusu ledvenega vretenca pri Pagetovi bolezni
Tip		članek
Vir		Radiol Oncol
Vol. in št.		Letnik 38, št. 4
Leto izdaje		2004
Obseg		str. 333-8
Jezik		eng
Abstrakt		Background. Paget's disease of bone typically demonstrates three evolutionary phases with the characteristic radiographic findings. The incipient stage is manifested by an advancing lytic zone of resorption. Unlike the skull and the long bones the primary advancing zone of rarefication has not been clearly demonstrated within the spine and pelvis. Case report. A 62-year-old man with histologically proved polyostotic Paget's disease was admitted to the hospital due to the exacerbation of pain at the toracolumbar junction with deterioration during the night. Due to slight elevation of acid phosphatase and clinical signs indicating prostatic hypertrophy the possibility of metastatic prostatic carcinoma has been raised. A bone scintigraphy with technetium phosphonate showed the expected marked increased uptake affecting numerous bones with the typical radiographic signs of Paget's disease. Besides these findings, there was also moderate focal accumulation within the right dorsal half of the vertebral body of L1. Conventional tomography, computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated the primary cutting zone of resorption affecting the same region. Conclusions. We present a unique case of Paget's disease with primary V-cutting zone within the undeformed vertebral body of L1 and spontaneous progression to the midphase of the disease on a three year follow-up.
Izvleček		Izhodišča. Potek Pagetove bolezni kosti ima tri razvojne faze z značilnimi radiografskimi znaki. V začetni fazi je prisotna napredujoča cona kostne resorpcije. Primarna napredujoča cona osteolize ni bila nikoli jasno prikazana na hrbtenici in medenici, kot je bila na lobanji in dolgih kosteh. Prikaz primera. 62-letni bolnik s histološko potrjeno diagnozo poliostotske Pagetove bolezni je bil sprejet v bolnico zaradi bolečin v višini torakolumbalnega prehoda, ki so se ponoči stopnjevale. Zaradi zmerno zvišane kisle fosfataze ter kliničnih znakov hipertrofije prostate je bil postavljen sum na karcinom prostate. Kostna scintigrafija s tehnecijevim fosfonatom je pokazala pričakovano nabiranje radiofarmaka na številnih kostnih elementih s tipičnimi radiografskimi znaki Pagetove bolezni. Razen omenjenega se je pokazalo zmerno žariščno nabiranje radiofarmaka tudi v desni dorzalni polovici korpusa vretenca L1. V istem področju so klasična tomografija, računalniška tomografija (CT) ter magnetnoresonančna tomografija (MRI) prikazale primarno cono kostne resorpcije. Zaključki. Prikazan je edinstven primer Pagetove bolezni s primarno cono kostne resorpcije v morfološko nespremenjenem korpusu vretenca L1. Po treh letih zasledovanja je prišlo do spontanega napredovanja v srednjo fazo bolezni.
Deskriptorji		OSTEITIS DEFORMANS SPONDYLOLYSIS TOMOGRAPHY, X-RAY COMPUTED MAGNETIC RESONANCE IMAGING MIDDLE AGE