You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 56-year old man presented with bony pain.  X-ray skull lateral view shows: and explain in detail?
Ref. Grainger and Allison's Diagnostic Radiology. Page. 483
 
Pagets disease of bone affects each person differently . It includes :
1 Bones : Pain in the affected bones is the most common symptom of pagets disease of bone.
  Skull in Pagets disease 

osteoporosis circumscripta: large, well-defined lytic lesion
cotton wool appearance: mixed lytic and sclerotic lesions of the skull
diploic widening: both inner and outer calvarial tables are involved, with the former usually more extensively affected
Tam o'Shanter sign: frontal bone enlargement, with the appearance of the skull falling over the facial bones, like a Tam o' Shanter hat