Rare case of paget’s disease with co-existing features of ankylosing spondylitis

Introduction: Paget’s disease is an uncommon metabolic skeletal disorder characterized by increased osteoclast-mediated bone resorption & compensatory excessive osteoblastic activation. It often incidental finding can also rarely co-exist with other disorders like ankylosing spondylitis.Materials Methods: Observational type of case study using computed tomography (CT) and X-Ray. 80 years old male came complaints giddiness fall decreased speech output. CT scans showed intraventricular hemorrhage patient was treated for the same. However, revealed features suggesting co-existing spondylitis a survey whole body done. Increased S. Alkaline Phosphatase (187 U/L) low Calcium (7.5 mg/dl) noted.Results: Brain mixed lytic sclerotic changes widened diploic space coarse trabeculae involving calvarium fully giving cotton wool appearance. Spine imaging revealed, picture framing some vertebrae, anterior lateral syndesmophytic fusion bamboo spine appearance diffuse osteopenia multiple areas. X-Ray pelvis Kohler tear drop sclerosis near complete bilateral sacroiliac joints. Conclusion: Paget shows abundance patterns on that are related to pathologic stage disease. Recognition spectrum usually allows early diagnosis differentiation its complications, which helps guide therapy improve management.