Paget's disease of bone in the patient presented with a bowed leg.

KEY CLINICAL MESSAGE: In dealing with bowed limbs along with increased alkaline phosphatase (ALP), even if the typical changes to the face are not very noticeable at first glance, Paget's disease of the bone (PDB) should be suspected, and the necessary investigations should be carried out to confirm the diagnosis.

ABSTRACT: Paget's disease of the bone (PDB) is the second most prevalent metabolic bone disorder worldwide with disorganized bone remodeling. Here, a patient is presented with pain and bending of the right leg, whose skull and forehead changes are not noticeable at first glance, but with clinical suspicion and additional diagnostic evaluations, PDB diagnosis is confirmed for the patient.