The role of bone scanning in Paget's disease.

In Paget's disease, the bone scan allows visualisation of the whole skeleton, permitting accurate assessment of disease extent. The scan appearances are usually characteristic, and as uptake of tracer depends upon skeletal metabolic activity, this study reflects the severity of Paget's disease, in addition to providing early appreciation of alterations in disease activity. While correlation of x-rays and bone scans in Paget's disease have shown that neither method alone detects all lesions, it is clear that the bone scan is the more sensitive technique. In addition, those sites that are occasionally missed by bone scan are metabolically inactive. The bone scan is the investigation of choice in Paget's disease, and radiology should be used to provide supplementary information, as and when required.