Finding-the-Path: Plain radiographs of ankle including distal tibia

Plain radiographs of the left ankle show coarse trabeculation of the distal tibia with areas of lucency in the subcortical region (white arrows) and areas of cortical thickening, indicating Paget's disease. An incomplete lucent line consistent with fracture is noted in the tibial shaft (black arrows). The diagnosis is Paget's disease with incomplete fracture of the tibial shaft.

Which do you do next?

• MRI of the left ankle
• CT of the left ankle
• Plain radiographs of the entire left leg
• Bone scintigraphy
• Treat the fracture