Radiological demonstration of healing in Paget's disease of bone treated with APD

Twenty-three patients with Paget's disease received the bisphosphonate APD and were examined radiologically every 6 months. Because routine roentgenographic procedures were followed, a number of the X rays were not fit for comparison. The radiographic technique, as well as the positioning of the patients, is critical since both could lead to artefacts. All patients reached normal biochemical levels, usually within 6 months. Out of the 23 patients 11 showed definite radiological improvement in one or more lesions; probable improvement was seen in another three. Of the 65 individual lesions, with films that were comparable, 30% definitely and 20% probably improved; 50% did not change but deterioration was never encountered. Osteolytic lesions in the long bones are most suitable for the evaluation of radiological changes and follow-up of these lesions during treatment should be most rewarding.