What is the most characteristic finding of Paget's disease?

The most characteristic finding of Paget's disease is abnormal bone remodeling. Paget's disease is a chronic disorder that can result in enlarged and deformed bones due to an imbalance in the normal cycle of bone formation and breakdown. In healthy bone, these processes occur in a balanced manner, but in Paget's disease, there is excessive bone resorption followed by disorganized and excessive bone formation. This leads to structural abnormalities in the affected bones, which can become weak, misshapen, and prone to fractures.

This abnormal remodeling is what distinguishes Paget's disease from other bone conditions. Unlike osteoporosis, where the overall bone density is decreased leading to fragility, Paget's disease involves areas of increased bone turnover that can be disorganized, resulting in both enlarged and structurally weak bones. Therefore, the identification of this abnormal remodeling serves as a key diagnostic criterion for Paget's disease.