“facies leontina”

Clinical photograph:

Broad cheeks, ears standing out from head, arched flaring nostrils, wide coarse nose, pronounced forehead.b. Enlarged skull

Skull X-rays:

Thickening of the cranium, osteolysis, patchy new bone formation resulting in a "cotton-wool" appearance.

Bone scan:

Due to their elevated metabolic rates, Pagetic bone lesions appear as focal areas of markedly increased uptake ("hot") spots.