About paget's disease of bone

What is paget's disease of bone?

Paget's disease facts

  • Paget's disease is a chronic bone disorder.
  • Paget's disease frequently causes no symptoms.
  • Paget's disease can cause pain in the bones or joints, headaches and hearing loss, pressure on nerves, increased head size, bowing of limb, or curvature of spine.
  • Tests used to diagnose Paget's disease include X-rays, blood tests, and bone scanning.
  • Paget's disease can lead to other medical conditions.
  • Medical treatment options include aspirin, other anti-inflammatory medications, pain medications, and medications that slow the rate of bone turnover, decreasing the activity of Paget's disease.
  • Surgical operations may necessary for damaged joints, fractures, severely deformed bones, or when nerves are being pinched by enlarged bone.

What is Paget's disease?

Paget's disease is a chronic condition of bone characterized by disorder of the normal bone remodeling process. Normal bone has a balance of forces that act to lay down new bone and take up old bone. This relationship (referred to as "bone remodeling") is essential for maintaining the normal calcium levels in our blood. In bone affected by Paget's disease, the bone remodeling is disturbed and not synchronized. As a result, the bone that is formed is abnormal, enlarged, not as dense, brittle, and prone to breakage (fracture).

Paget's disease affects older skeletal bone of adults. It's estimated that 1% of adults in the U.S. have Paget's disease. There is also an extremely rare form of Paget's disease in children, referred to as juvenile Paget's disease. Paget's disease is also known as osteitis deformans.

What are the symptoms for paget's disease of bone?

Most people who have Paget's disease of bone have no symptoms. When symptoms occur, the most common complaint is bone pain.

Because this disease causes your body to generate new bone faster than normal, the rapid remodeling produces bone that's softer and weaker than normal bone, which can lead to bone pain, deformities and fractures.

The disease might affect only one or two areas of your body or might be widespread. Your signs and symptoms, if any, will depend on the affected part of your body.

  • Pelvis. Paget's disease of bone in the pelvis can cause hip pain.
  • Skull. An overgrowth of bone in the skull can cause Hearing loss or headaches.
  • Spine. If your spine is affected, nerve roots can become compressed. This can cause pain, tingling and Numbness in an arm or leg.
  • Leg. As the bones weaken, they may bend — causing you to become bowlegged. Enlarged and misshapen bones in your legs can put extra stress on nearby joints, which may cause osteoArthritis in your knee or hip.

When to see a doctor

Talk to your doctor if you have:

  • Pain in your bones and joints
  • Tingling and weakness
  • Bone deformities

What are the causes for paget's disease of bone?

The cause of Paget's disease of bone is unknown. Scientists suspect a combination of environmental and genetic factors contribute to the disease. Several genes appear to be linked to getting the disease.

Some scientists believe Paget's disease of bone is related to a viral infection in your bone cells, but this theory is controversial.

What are the treatments for paget's disease of bone?

The treatment of Paget's disease is directed toward controlling the disease activity and managing its complications. When Paget's disease causes no symptoms and blood testing shows that the level of serum alkaline phosphatase is normal or minimally elevated, no treatment may be necessary. Bone pain can require anti-inflammatory drugs (NSAIDs) or pain-relieving medications. Bone deformity can require supports such as heel lifts or specialized footwear. Surgical operations may be necessary for damaged joints, fractures, severely deformed bones, or when nerves are being pinched by enlarged bone. Prior to undergoing an operation on bone affected by Paget's disease, it is helpful to be treated with medications, such as bisphosphonates or calcitonin (Miacalcin), as this tends to diminish the risk of surgical complications, including bleeding.

The medical treatment of the bone of Paget's disease involves either medications called bisphosphonates or injectable calcitonin. These drugs are also used to treat certain patients with osteoporosis.Bisphosphonates are the mainstay of treatment. There are a number of these available that are taken by mouth, including alendronate (Fosamax), risedronate (Actonel), etidronate (Didronel), and tiludronate (Skelid), and that are administered intravenously, including pamidronate (Aredia) and zoledronate (Reclast). In general, oral bisphosphonates are taken first thing in the morning on an empty stomach with 8 ounces of water. They can cause irritation of the stomach and esophagus. Intravenous bisphosphonates can cause temporary muscle and joint pain but are not associated with irritation of the stomach or esophagus.

What are the risk factors for paget's disease of bone?

Factors that can increase your risk of Paget's disease of bone include:

  • Age. People older than 40 are most likely to develop Paget's disease of bone.
  • Sex. Men are more commonly affected than are women.
  • National origin. Paget's disease of bone is more common in England, Scotland, central Europe and Greece — as well as countries settled by European immigrants. It's uncommon in Scandinavia and Asia.
  • Family history. If you have a close relative who has Paget's disease of bone, you're more likely to develop the condition.

Video related to paget's disease of bone