Paget's Disease of Bone
Key Points
Key Points
- Paget’s disease of bone (osteitis deformans) is a chronic benign disorder of bone that generally affects one or several bones.
- The abnormal bone structure may be associated with enlarged affected bones and skeletal deformity, particularly in weight-bearing bones.
- Many patients with Paget’s disease of bone are asymptomatic. Bone pain, mild to moderate in intensity and described as deep and aching, is a feature of Paget’s disease of bone, usually developing late rather than early in the disease process, and it is only present in a minority of patients.
- The clinical features and complications of Paget’s disease are closely related, but presentation varies from patient to patient.
- The most common neurological complication of Paget’s disease is hearing loss associated with disease involving the skull.
- Studies of patients with Paget’s disease indicate there is a family history of the disorder, an autosomal dominant transmission pattern, in 5%–40%, with most researchers reporting a 10%–20% incidence.
- Paget’s disease affects both men and women, with an apparent small male predominance. It rarely manifests itself clinically before age 40, and the frequency of the condition increases with advancing age.
- Rates in the United States are estimated to be approximately 2%–3% among individuals older than 55 years.
Diagnosis
Diagnos...
...maging...
...ents with suspected Paget’s dise...
...iagnosed with Paget’s disease, the...
...ochemistry
...recommends that after radiological diagnosis...
...e 1. Symptoms and Complications of Paget’s Dise...
Treatment
...reatmen...
...ble 2. Recommended Bisphosphonate Dosin...
...ications
...commends treatment with a bisphosphonate...
...of Medication
...uggests a single 5-mg dose of IV zole...
...the Response to Treatment...
...is urgency in the control of symptoms or the d...
The ES suggests that patients who have osteo...
...ining Remissio...
...uggests that to maximize the duration of rem...
...elapse and Retreatment
...S recommends that in patients with in...
...ic Paget’s Disease...
The ES suggests that amino-terminal propept...
...nt of the Complications of Paget’...
Hearing Lo...
The ES suggests treatment with a potent b...
Osteoarthriti...
...sts the use of analgesics as adjunctiv...
...nts with severe osteoarthritis adjacent to Pa...
...ng of Lower Extremit...
...he ES suggests treatment with a potent bi...
...lysis...
...ses of paraplegia associated with P...
...oplasms
...ES suggests that patients with osteosarcoma...
...stive Heart Fail...
...ggests treatment with a bisphosphonate in patien...