| 英文摘要 |
A 53-year-old woman, who has a history of chronic pain over her head, jaw, trunk, bilateral shoulders, forearms, hips, knees, and lower limbs for 20 years. She had been informed to have a congenital skeletal abnormally by several physicians and no therapy was indicated. She received opioids combination therapy to control her pain, which was devastating, at our Hospice care out-patient clinic in recent 6 months. Osteitis deformans (Paget's disease) was diagnosed after she was referred to our rheumatologist. Skull X-ray showed diffused sclerotic changes and other bones showed both osteolytic and osteoblastic changes. These changes are pathognomic for Paget's disease, which is a chronic disorder of excessive breaking down and formation of bone tissue causing enlarged and misshapen bones. She had a great improvement of pain after intravenous infusion of zoledronic acid 5mg (Aclasta(R)). This image is the most severe Paget's disease involving the skull that had been published in current literature, and which the diagnosis had been delayed for 20 years in the patient. |
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