Paget's disease Flashcards
What is Paget’s disease of bone?
Paget’s disease of bone involves excessive and uncoordinated bone turnover, leading to patchy areas of high and low bone density, enlarged bones, structural problems, and increased fracture risk. It typically affects older adults and the axial skeleton.
What is the cause of Paget’s disease?
The exact cause is unknown but thought to involve genetic and environmental factors.
What are the typical presentations of Paget’s disease?
- Bone pain
- Bone deformity
- Fractures
- Hearing loss (if it affects bones of the ear)
What are the key X-ray findings in Paget’s disease?
- Bone enlargement and deformity
- Osteoporosis circumscripta
- Cotton wool appearance of the skull
- V-shaped osteolytic defects in the long bones
What are the blood test findings in Paget’s disease?
- Raised alkaline phosphatase (ALP)
- Normal calcium
- Normal phosphate
What is the main treatment for Paget’s disease?
Bisphosphonates are the main treatment, inhibiting osteoclast activity and restoring normal bone metabolism.
What are other treatment options for Paget’s disease?
- Calcitonin (if bisphosphonates are unsuitable)
- Analgesia (e.g., NSAIDs) for bone pain
- Calcium and vitamin D supplementation if necessary
- Surgery for fractures, deformities, or arthritis
How is the effectiveness of Paget’s disease treatment monitored?
Effectiveness is monitored by checking serum alkaline phosphatase (ALP) levels and reviewing symptoms.
What are the key complications of Paget’s disease?
- Hearing loss (if it affects bones of the ear)
- Heart failure (due to hypervascularity)
- Osteosarcoma
- Spinal stenosis and spinal cord compression
What is osteosarcoma in relation to Paget’s disease?
Osteosarcoma is a rare but serious complication presenting with focal bone pain, swelling, or pathological fractures.
How is spinal stenosis diagnosed and treated in Paget’s disease?
Diagnosed with an MRI scan; treatment may involve bisphosphonates and possibly surgical intervention.
