The scintigraphic features and low dose CT findings are most compatible with Paget disease.
The patient was asymptomatic.
Other clinical features of Paget's disease which are not present in this case:
Fatigue, pain, tenderness
Increase hat size
Hyperthermia from hypervascularity
Cranial nerve deficit(s), pulsatile tinnitus
New pain/swelling → malignant transformation
High output cardiac failure, heart block