Paget's Disease

Question 1

What is Paget’s disease of the bone?

Answer 1

Disorder of bone turnover. It results in excessive bone turnover due to excess activity of osteoblasts and osteoclasts. This results in disorganised areas of sclerotic and lytic bone.

Question 2

What are the risk factors for Paget’s disease?

Answer 2

Increasing age,
Family history,
Male sex,
Northern latitude,

Question 3

What is the presentation of Paget’s disease of the bone?

Answer 3

Bone pain,
Bone deformity,
Fractures
Hearing loss (if bones of the ear are affected).

Question 4

What are the X ray findings in Paget’s disease?

Answer 4

Osteolysis, increased bone size and sclerosis, osteolytic lesions, pathological fractures

Question 5

What are the blood results in Paget’s disease?

Answer 5

Raised ALP
Normal calcium
Normal phosphate

Question 6

What is the management of Paget’s disease?

Answer 6

Main treatment: Bisphosphonates - restore normal bone metabolism.
Adjunctive treatments: NSAIDs, calcium and vit D supplements

Question 7

What are the complications of Paget’s disease?

Answer 7

• Osteosarcoma (bone cancer with poor prognosis)
• Spinal stenosis and cord compression
  Others: Osteoarthritis, pain, deformity, hearing loss, nerve compression