You might answer that I should just run the tool, well I have, several times, and instead of defragmenting this terrible pagefile situation, the tool crashes and nothing is done, one of the few times I can remember a Sysinternals tool crashing.
Let this serve as a reminder about why you don't let Windows grow the pagefile as needed, you configure a fixed size and only change it when adding RAM, or you install applications, *cough* Exchange, that want voluminous pagefiles.
Update The first commenter said that many fragments shouldn't cause the tool to crash, and I would agree, but here is the Application log entry from good ole Doc Watson - Event 4097
The application, C:\pagedfrg\pagedfrg.exe, generated an application error The error occurred on 09/15/2006 @ 13:12:47.270 The exception generated was c0000005 at address 00401CBC (pagedfrg)
And here is the generic Application Error in the Application log, Event 1000
Faulting application pagedfrg.exe, version 2.32.0.0, faulting module pagedfrg.exe, version 2.32.0.0, fault address 0x00001cbc