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
...Diagnosis...
...Imaging...
...with suspected Paget’s disease, th...
...ents diagnosed with Paget’s disea...
...Biochemis...
...S recommends that after radiologica...
...Symptoms and Complications of Paget’s Di...
Treatment
...Treatment...
...ecommended Bisphosphonate Dosing R...
...Indications...
...ecommends treatment with a bisphosp...
...Choice of Medicatio...
...ests a single 5-mg dose of IV zoledronate as...
...Ass...
...s urgency in the control of symptoms...
...ES suggests that patients who have osteolytic lesi...
...Maintaining Remissi...
...he ES suggests that to maximize the duration...
...Relapse and Retreatmen...
...ends that in patients with increased b...
...Monostotic P...
...that amino-terminal propeptide of type 1...
...Management of the Complicati...
...Hearing Loss...
...ests treatment with a potent bisphosphonate...
...Osteoarthritis...
...ests the use of analgesics as adjuncti...
...patients with severe osteoarthritis a...
...Bowing of Lower Ex...
...suggests treatment with a potent bisphosphonate...
...Paralysis...
...araplegia associated with Paget’s disease of...
...Neoplasms...
...that patients with osteosarcoma or...
...Congestive He...
...treatment with a bisphosphonate in patient...