Paget’s disease of bone

Question 1

This condition is a disease of what?

Answer 1

Excessive bone turnover due to excessive activity of both osteoblasts and osteoclasts

Question 2

1) This excessive turnover is not coordinated, leading to patchy areas of what?
2) This leads to what?
3) Which part of the skeleton is affected the most?

Answer 2

1) High density (sclerosis) and low density (lysis)
2) Enlarged and misshapen bones with structural problems that increase the risk of pathological fractures
3) Axial skeleton

Question 3

This condition typically occurs in older adults, name 2 ways it can present

Answer 3

• Most commonly presents asymptomatic
• Bone pain
• Bone deformity
• Fractures
• Hearing loss can occur if it affects the bones of the ear

Question 4

1) What is the key finding in biochemistry?
2) What is the key finding on xray?

Answer 4

1) Raised ALP
2) Enlarged and deformed bones

Question 5

1) What drugs is the main treatment?
2) Name other drugs that can be used

Answer 5

1) Bisphosphonates
2) NSAIDs, calcium and vitamin D supplementation

Question 6

What are the 2 main complications?

Answer 6

• Osteosarcoma
• Spinal stenosis and compression

Question 7

1) What is osteosarcoma?
2) How does it present?
3) It can normally be seen on what imaging modality?

Answer 7

1) Bone cancer with a poor prognosis
2) Increased focal bone pain, bone swelling or pathological fractures
3) X-ray

Question 8

1) What is spinal stenosis and compression?
2) How is it diagnosed?
3) How can it be treated?

Answer 8

1) Where a deformity in the spine leads to spinal canal narrowing and if this narrowing presses on the spinal nerves it causes neurological signs and symptoms
2) MRI
3) Bisphosphonates