In Paget disease of bone, which radiographic finding is indicative of the condition?

In Paget disease of bone, the hallmark radiographic finding is the presence of a mosaic pattern of bone, which reflects the disorganized and chaotic remodeling that occurs in this condition. This pattern arises as a result of abnormal osteoclastic activity followed by compensatory osteoblastic activity, leading to the jumbled appearance of trabecular and cortical bone.

The mosaic pattern typically manifests as irregularly shaped, structurally disorganized bone with interspersed areas of lytic lesions, sclerosis, and thickened sections. This characteristic change in the bone architecture is a direct result of the disease's pathophysiology, which includes increased bone turnover and abnormal bone formation.

In Paget disease, you may also encounter lytic lesions and areas of diffuse sclerosis as the disease progresses, but it is the mosaic pattern that distinctly differentiates it from other bone pathologies. Other conditions like osteopetrosis exhibit a different radiographic appearance, characterized by excessive sclerosis without the typical mosaic pattern seen in Paget's disease.