Paget's Disease of Bone

Publication Date: December 1, 2014

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

...iagnosis

Imagin...

...ith suspected Paget’s disease, the E...

...diagnosed with Paget’s disease, the ES...


...iochemistry

...recommends that after radiological diagnosis of...


Table 1. Symptoms and Complications of Paget’...


Treatment

...atment...

...e 2. Recommended Bisphosphonate Do...


...ications...

...recommends treatment with a bisphosphonate (s...


...ice of Medication...

...ggests a single 5-mg dose of IV zo...


...he Response to Treatment...

...ncy in the control of symptoms or the disea...

...sts that patients who have osteolytic le...


...taining Remission...

...sts that to maximize the duration of remission, b...


...apse and Retreatme...

...ES recommends that in patients with increased b...


...otic Paget’s Disease...

...ts that amino-terminal propeptide of type 1...


...t of the Complications of Paget’s Disease...

...ing Loss...

...ts treatment with a potent bisphosphonate to preve...

...eoarthritis...

...gests the use of analgesics as adjunctive ther...

...patients with severe osteoarthritis adjacent to P...

...owing of Lower Ex...

...suggests treatment with a potent bi...

...lysis...

...araplegia associated with Paget’s disease...

...plasms

...S suggests that patients with osteosarcoma...

...stive Heart Failure...

...ests treatment with a bisphosphonate in...