Diaphyseal presentation of Paget disease in long bones

The authors report a case of polyostotic Paget disease including bilateral tibial involvement with sparing of the ends of each bone. Bone scans with technetium-99m-methylene diphosphonate demonstrated increased activity at the ends of the tibiae, suggesting atypical progression from the shaft toward the joint. This appears to be the first such report to include scintigraphic correlation.