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...
...patients with suspected Paget’s disease, the...
...tients diagnosed with Paget’s disease, the...
...hemistry
...e ES recommends that after radiological diag...
...ES recommends measuring a specific marker of bo...
...s and Complications of Paget’s Disease of Bon...
Treatment
...eatment...
...2. Recommended Bisphosphonate Dosing Re...
...dication...
...s treatment with a bisphosphonate (see Table 2)...
...ce of Medication...
...gests a single 5-mg dose of IV zoledronate as the...
...the Response to Treatment...
...f there is urgency in the control of...
The ES suggests that patients who have osteoly...
...aintaining Remission
The ES suggests that to maximize the duration of...
...elapse and Retreatment
...mends that in patients with increased...
...c Paget’s Disease...
...ES suggests that amino-terminal propeptide of t...
...the Complications of Paget’s Disease...
Hearing Lo...
...treatment with a potent bisphosphonate to p...
...steoarthriti...
The ES suggests the use of analgesics a...
...th severe osteoarthritis adjacent to Paget’s d...
...of Lower Extremit...
...treatment with a potent bisphosphona...
...lysis
...paraplegia associated with Pagetâ€...
Neoplasms
...uggests that patients with osteosarcoma...
...ive Heart Failure...
...suggests treatment with a bisphospho...