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Paget's Disease of Bone: Imaging Diagnosis, Differential Diagnosis, and Modern Management – A Comprehensive Radiology Case Review

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Clinical Hook A 57-year-old man initially presented with chronic right knee pain. Over time, he noticed progressive warmth and enlargement of his right thigh without significant limitation of joint motion. Conventional radiographs demonstrated extensive cortical thickening, coarse trabecular remodeling, and diffuse enlargement involving the right hemipelvis and femur. Bone scintigraphy revealed markedly increased radionuclide uptake throughout the involved skeleton, suggesting highly active bone remodeling. Although the total serum alkaline phosphatase level remained within the normal range, bone-specific alkaline phosphatase was significantly elevated, emphasizing that biochemical activity may remain occult unless bone turnover markers are specifically evaluated. Following risedronate therapy, clinical symptoms improved, and follow-up bone scintigraphy showed decreased metabolic activity after 18 months. This representative case illustrates why Paget's disease continues to challen...
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Air Bronchogram Explained: Imaging Findings, Differential Diagnosis, and AI in Modern Chest Radiology

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Air Bronchogram Explained: The Chest X-ray Sign Every Radiologist Must Recognize Introduction Every day, thousands of chest radiographs are interpreted in emergency departments and intensive care units around the world. Although artificial intelligence has become increasingly capable of detecting pulmonary abnormalities, there remains one classic radiologic sign that every radiologist, pulmonologist, emergency physician, and critical care specialist must immediately recognize—the air bronchogram . This seemingly simple imaging finding often represents the difference between early recognition of life-threatening alveolar disease and delayed diagnosis. Whether encountered in severe bacterial pneumonia, pulmonary edema, acute respiratory distress syndrome (ARDS), pulmonary hemorrhage, or certain lung malignancies, an air bronchogram provides direct evidence that the surrounding alveoli have lost their normal air content while the bronchi remain patent. The clinical importance of th...
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