A 48-year-old woman, who was previously diagnosed with Paget's bone disease, referred to our Metabolic Bone Diseases Outpatient Clinic complaining of chronic, non-traumatic pain at the left foot. Clinical examination revealed that the left forefoot, as opposed to the right one, was enlarged, deformed and painful on finger pressure, particularly at the metatarsal and the 2nd interphalangeal joint level. Skin upon the 2nd toe appeared slightly thickened.