Paget's Disease of Bone: Symptoms, Treatment

Overview

Paget’s disease of bone is the second most common type of bone disease after osteoporosis. It is a disorder of the bone remodeling process, in which the body absorbs old bone and forms abnormal new bone. It can cause your bones to grow too large and weak. The abnormal bones might break easily. The condition is also known as osteitis deformans and Paget’s disease.

Paget’s disease of bone is most common in the spine, pelvis, skull, and legs. It might affect one or several bones, but not your entire skeleton. Men are more likely to develop the disease than women. It is more common in older people. In the United States, about 1 million people have Paget’s disease.

Cause

The cause of Paget’s disease is unclear. Experts suspect that a combination of environmental and genetic factors contribute to the disease. Factors that may increase your risk of Paget’s disease of bone include:

  • Age.

People over 40 years old are most likely to develop Paget’s disease of bone.

  • Sex.

Men are more commonly affected than women.

  • Ethnic groups.

Paget’s disease of bone is more common in England, Scotland, central Europe and Greece — as well as countries settled by European immigrants.

  • Family history.

If you have a relative who has Paget’s disease of bone, you’re more likely to develop the condition. Because several genes appear to be linked with getting the disease, such as the Sequestrosome 1 gene on chromosome 5.

Symptoms

Paget’s disease causes no symptoms in most of patients. When symptoms occur, the most common complaint is bone pain. Some people also get arthritis in joints near the affected bones. They are more at risk of breaking the affected bone. Other signs and symptoms that can be used to make initial diagnosis are:

  • Enlarged bones
  • Broken bones
  • Damaged cartilage in joints
  • Swelling of joints
  • Tenderness or redness of the skin covering the affected bone

Early diagnosis and treatment can prevent some symptoms from getting worse

Diagnosis

To check for Paget’s disease of bone, your doctor may first conduct a physical exam. The exam can demonstrate abnormalities of the skeletal shape or bone deformities. Then, He or she may order imaging tests and blood tests to help confirm the diagnosis of Paget’s disease of bone.

Imaging tests that can reveal bone changes common to Paget’s disease of bone include:

  • X-rays.

The first indication of Paget’s disease of bone is often abnormalities found on X-rays done for other reasons. X-ray images of your bones can show areas of bone reabsorption, enlargement of the bone and deformities. These are characteristic of Paget’s disease of bone.

  • Bone scan.

In this test, radioactive material is injected into your body. This material travels to the spots on your bones most affected by Paget’s disease of bone, so they light up on the scan images.

The most effective lab test for diagnosing Paget’s disease of bone is alkaline phosphatase (ALP) level test. People with the disorder have an excess of alkaline phosphatase, an enzyme, in the blood. However, many other diseases or conditions might be the cause of elevated alkaline phosphatase levels.

Treatment

Effective and safe treatment methods can help most people with Paget’s disease.

The medical treatment of Paget’s disease is focused on controlling the disease activity and managing its complications. Medications that may be helpful in treating the disorder include:

  • Anti-inflammatory drugs (NSAIDs) to reduce bone pain
  • Bisphosphonates to help reduce the breakdown of disordered bone, such as alendronate (Fosamax) and ibandronate (Boniva)
  • Calcitonin (Miacalcin) if you cannot tolerate bisphosphonates

Treatment for Paget’s disease can also focus on providing physical assistance, including the addition of wedges in the shoe, canes as walking aids and the administration of physical therapy.

In occasional cases, surgery might be required to help:

  • Help fractures heal
  • Replace joints damaged by severe arthritis
  • Realign deformed bones
  • Reduce pressure on nerves

However, medical treatment is not expected to correct some of the changes of the Paget’s disease that have already occurred, such as hearing loss, deformity or osteoarthritis. So, prompt diagnosis and proper treatment are rather important.


Keyword: Paget’s disease of bone.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.