What type of radiographic feature is seen in the later stages of Paget's disease?

In the later stages of Paget's disease, the characteristic radiographic feature is the "cotton wool" appearance. This description arises from the way the affected bones appear on imaging studies, where there are areas of radiolucency and radiopacity that result in a mottled or fluffy appearance resembling cotton wool.

Paget's disease is a chronic bone disorder that can lead to enlarged and deformed bones. During the later stages of the disease, there is disorganized bone remodeling, which contributes to this distinctive imaging feature. The "cotton wool" spots are indicative of osteoclastic activity, followed by inadequate osteoblastic response, leading to these characteristic changes.

While other descriptions exist, such as "ground glass" appearance (often associated with other conditions like fibrous dysplasia), "beaten copper" (more commonly referred to regarding craniotabes), and "osteoporotic pattern" (which relates to bone density loss seen in osteoporosis), none match the specific findings attributed to the advanced stages of Paget's disease as closely as the "cotton wool" appearance. Thus, recognizing this feature is key for clinicians and radiologists in diagnosing and managing the condition.