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A case series of Paget's disease of bone: diagnosing a rather uncommon condition in Singapore.

Paget's disease of bone is an uncommon condition in the Asian population, with only 2 cases reported in medical literature so far. We discuss 5 cases of Paget's disease who presented over an 8-year period with a wide and interesting variety of clinical features. Though 4 out of the 5 patients were asymptomatic, all of them had characteristic radiological features and elevated serum alkaline phosphatase levels of varying degrees. Diagnosis was based on the clinical features, the elevated serum alkaline phosphatase levels, and most importantly, the distinctive radiographic features, which are almost pathognomonic of the condition. The incidence of Paget's disease is probably under-reported in Asia and Singapore, as it is rarely encountered and can be easily overlooked due to its usually asymptomatic and benign nature. A high index of suspicion and an active search for its typical features are thus essential for its detection.