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
...Imaging...
...s with suspected Paget’s disease, the Endocrine...
...tients diagnosed with Paget’s disease, the...
...B...
...recommends that after radiological...
...1. Symptoms and Complications of Paget...
Treatment
Treatme...
...able 2. Recommended Bisphosphonate Dosing Reg...
...Indicat...
...ds treatment with a bisphosphonate (see...
...Choice of Medicati...
...a single 5-mg dose of IV zoledronate as...
...Assessing th...
...ency in the control of symptoms or the dis...
...sts that patients who have osteolytic...
...Maintaining R...
...e ES suggests that to maximize the duration...
...Relapse and Ret...
...S recommends that in patients with increase...
...that amino-terminal propeptide of ty...
...Management o...
...Hearing Los...
...ES suggests treatment with a potent bisphosph...
...Osteoar...
...the use of analgesics as adjunctive therapy...
...or patients with severe osteoarthritis adjace...
...Bowing of Lo...
...sts treatment with a potent bisphosphonate before...
...Paralysis...
...araplegia associated with Paget’s di...
...Neoplasms...
...he ES suggests that patients with osteo...
...Congest...
...ts treatment with a bisphosphonate in...