Paget's disease

Question 1

What are the clinical features of Paget’s disease?
What liver marker is typically raised?
What findings may be present on x-ray?

Answer 1

Typically older male with bone pain and isolated raised ALP
Bone pain
Bowing of tibia, bossing of skull

x-ray:
Thickened vault
Osteoporosis circumscripta
Cotton wool appearance
V-shaped defects in long bones

Question 2

What treatment is given in Paget’s disease?

Answer 2

Bisphosphonate:

oral risedronate or IV zoledronate

Question 3

What complications can arise due to Paget’s disease?

Answer 3

Osteosarcoma - a type of bone cancer
Spinal stenosis
Hearing loss - due to cranial nerve entrapment