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
...agnosis...
Imagin...
...h suspected Paget’s disease, the Endocrine Soci...
...nts diagnosed with Paget’s disease, the ES su...
...ochemistr...
...recommends that after radiological diagno...
.... Symptoms and Complications of Pa...
Treatment
...eatment...
...mmended Bisphosphonate Dosing RegimensHaving t...
Indication...
...S recommends treatment with a bisphosph...
...oice of Medicatio...
...gests a single 5-mg dose of IV zoledronate...
...he Response to Treatment...
...rgency in the control of symptoms or the d...
...s that patients who have osteolytic lesions...
...taining Remission...
...s that to maximize the duration of remi...
...se and Retreatment...
...S recommends that in patients with increased bon...
...otic Paget’s Disease...
...S suggests that amino-terminal propeptide of typ...
...e Complications of Paget’s Disease...
...ing Loss...
...ests treatment with a potent bisphosphonate...
...oarthritis
...gests the use of analgesics as adjunctive therapy...
...patients with severe osteoarthritis ad...
...g of Lower Extremity...
...ggests treatment with a potent bisphosp...
...alysis
...of paraplegia associated with Paget’s diseas...
...oplasms...
...e ES suggests that patients with osteosarcoma or...
...ive Heart Failure...
...s treatment with a bisphosphonate in patients with...