Question:hard
This X-ray of the skull shows which lesion?
This X-ray of the skull shows which lesion?
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Cotton-wool fluffy sclerosis with widened diploe.
Updated On: Jun 24, 2026
- Paget's disease
- Multiple myeloma
- Osteosarcoma
- Osteomyelitis
Show Solution
The Correct Option is A
Solution and Explanation
Step 1: Read the film for its texture. The skull tables are expanded and the diploic space is widened, dotted with woolly, ill-marginated patches of sclerosis - the cotton-wool skull - heaviest over the frontal region.
Step 2: This blend of bony enlargement, coarse trabeculae and mixed lucent-sclerotic foci reflects disordered, overactive remodelling, which is the defining process of Paget disease. Its skull spectrum runs from early osteoporosis circumscripta to the later cotton-wool and Tam o' Shanter appearances.
Step 3: Sort out the mimics. Myeloma deposits sharply punched-out lytic holes without bony expansion, osteosarcoma is an aggressive matrix-forming tumour rarely in the calvarium, and osteomyelitis shows infective lysis with sequestra. The expansile cotton-wool diploic pattern is uniquely Pagetic.
\[\boxed{\text{Paget's disease}}\]
Step 2: This blend of bony enlargement, coarse trabeculae and mixed lucent-sclerotic foci reflects disordered, overactive remodelling, which is the defining process of Paget disease. Its skull spectrum runs from early osteoporosis circumscripta to the later cotton-wool and Tam o' Shanter appearances.
Step 3: Sort out the mimics. Myeloma deposits sharply punched-out lytic holes without bony expansion, osteosarcoma is an aggressive matrix-forming tumour rarely in the calvarium, and osteomyelitis shows infective lysis with sequestra. The expansile cotton-wool diploic pattern is uniquely Pagetic.
\[\boxed{\text{Paget's disease}}\]
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