Paget's Disease of Bone

Question 1

What is Paget’s disease of the bone?

Answer 1

Disorder of bone turnover- excessive bone turnover

Question 2

What is excessive bone turnover due to?

Answer 2

Excessive osteoclast & osteoblast activity

Question 3

What does Paget’s disease of bone result in?

Answer 3

Enlarged misshapen bones + structural problems that increase risk of pathological fractures

Question 4

What part of skeleton does Paget’s particularly affect?

Answer 4

Axial

Question 5

Presnetation of Paget’s disease of bone?

Answer 5

• Bone pain
• Bone deformity
• Fractures
• Hearing loss can occur

Question 6

X-ray findings in Paget’s?

Answer 6

• Bone enlargement & deformity
• Osteoporosis circumscripta
• Cotton wool appearance of skull
• V-shaped defects in long bones

Question 7

Biochemistry of Paget’s?

Answer 7

• Raised alkaline phosphatase (ALP) + other LFTs normal
• Normal Ca
• Normal phosphate

Question 8

Main treatment of Paget’s

Answer 8

Bisphosphonates

Question 9

Other treatment options for Paget’s?

Answer 9

NSAIDs for bone pain

Ca + Vit D supplementation

Surgery (rarely required)

Question 10

What do you continuously monitor when someone has Paget’s?

Answer 10

Serum Alkaline phosphatase

ALP

Question 11

What is osteoporosis circumscripta?

Answer 11

Well defined osteolytic lesions that appear less dense compared with normal bone

Question 12

Complications of Paget’s disease?

Answer 12

Osteogenic sarcoma (osteosarcoma) 
Spinal stenosis

Question 13

What is osteosarcoma?

Answer 13

Presents with

• Increased focal pain
• Bone swelling
• Pathological fractures

Question 14

What is spinal stenosis?

Answer 14

Deformity in spine leads to spinal cord narrowing