[Paget disease or fibrous dysplasia of the radius?--A case report]

A 46 years old man, who showed a painful and progressive deformity of the left radius, is presented. After some months a fracture within the affected bone area occurred. The diagnostic procedures including X-ray, MRI, scintigraphy and histology were controversial. Both fibrous dysplasia and Paget's disease of bone were suspected. The critical analysis of all results concluded that the most likely diagnosis was fibrous dysplasia. Unaware of the diagnostic discrepancies, the patient received a therapy with pamidronate 3 x 60 mg intravenously, which improved symptoms. After 14 months, the patient complained again about pain in the left radius. After a second therapy with pamidronate the patient currently exhibits no symptoms. The controversial diagnostic results and the applied therapeutic procedure are discussed.