Idiopathic orbital inflammation following intravenous pamidronate

Abstract

Sir, A 71‐yr‐old gentleman was referred with known Paget's disease. He had presented previously with chronic intermittent back and left thigh pain. He had been partially deaf for 8 yr and had a transurethral resection of the prostate for benign prostate hyperplasia in 1996. He had been otherwise well. Physical examination showed an enlarged left thigh with reduction in internal rotation of the left hip. There were no other physical signs. The isotope bone scan showed increased activity with a typical Paget's pattern involving the upper two‐thirds of the left femur, right hemipelvis, lumbar spine at L2, thoracic spine at T11 and mid‐cervical spine. Radiology showed Pagetic change in the right hemipelvis and left femur with moderate degenerative disease in both hip joints. Biochemistry showed an elevated serum alkaline phosphatase of 222 IU/l (30–126) but was otherwise normal. Full blood count was normal.