Paget's disease Flashcards
clinical features of Paget’s Dx
majority of pts are asymptomatic skull: see deformity with enlargement, hearing loss and dizziness spine and pelvis: bone pain, spinal stenosis, and nerve compression Long bones: bowing deformities with increased fracture risk Bone tumors: osteosarcoma and giant cell tumors (usually benign)
What do we see on labs with Paget’s dx?
elevated serum and bone specific alkaline phosphatase >300 Calcium and phosphorus are normal but can be elevated in fracture or immobility
diagnosis of Paget’s dx is
combination of radiographic findings and elevated alkaline phosphatase no additional bone turnover tests or imaging is needed for diagnosis bone scan is more sensitive than XR and is helpful for documenting the extent and locations of skeletal involvement.
treatment of Paget’s dx
bisphosphonates
what causes Paget’s dx?
abnormal osteoclasts that cause focal areas of acclerated bone resorption and followed by increased osteoblast activity that lay down brittle terrible bone. See structurally weaker bone and areas of sclerosis.
what are commonly affected areas of the skeleton with Paget’s dx?
skull, pelvis, thoracic and lumbar spine. proximal femurs
how are most people discovered to have Paget’s
they are asymptomatic get routine labs and discover elevated alkaline phosphatase or get routine imaging and see a abnormality
of the symptoms that pts do present with, what do they have?
bone pain and worse pain with weight bearing.
do we ever check bone turnover markers for Paget’s dx?
no because they can be normal even if there’s active dx. Not used for diagnosis or monitoring.
Diagnosis of paget’s dx
labs and clinical presentation
do need a bone scan to locate and know the distribution of where the active dx is
Do we need a bone biopsy to diagnose Paget’s dx?
no we do not need it to diagnose or monitor dx.
What is seen on imaging with Paget’s dx?
can have radiographic abnormalities or even see lytic lesions.
clinical features of Paget’s Dx chart
