[Paget's disease with osseous demineralization (author's transl)]

Radiological diagnosis of Paget's disease which is based on hypertrophy of the osseous cortex, osteocondensation and a fibrillary appearance of the cancellous bone, can be rendered difficult when there is superadded demineralization. This is usual in the initial phase of the condition and take on the form of circumscribed osteoporosis. Such an appearance can however be misleading owing to its wide extent or to the number of localizations, as was the case in two of our cases; the diagnosis of Paget's disease must then be established from histological criteria. Besides this demineralization which is directly related to the morbid process in Paget's disease, calcium deficiency is known to modify the clinical and radiological symptomatology of Paget's disease. Our first two cases illustrate this fact and the remarkable effectiveness of "remineralization" therapy in such cases.