Paget's Disease of Bone

Question 1

def

Answer 1

excessive bone remodeling at one or more sites resulting in a structurally disorganised bone

Question 2

aetiology

Answer 2

idiopathic
genetic factors & viral infection
excessive bone resorption by abnormally large osteoclasts followed by increased bone formation by osteoblasts in a disorganised fashion
marrow spaces are filled with fibrous tissues and blood vessels

Question 3

epi

Answer 3

incidence increases with age

men and women are equally affected

Question 4

history

Answer 4

asymptomatic

may present with insidious onset pain aggravated by weight bearing & movement

Question 5

examination

Answer 5

bitemporal skull enlargement
spinal kyphosis
anterolateral bowing of femur, tibia, or forearm
skin over involved bone may be warm due to increased vascularity
sensorineural deafness with compression of vestibulocochlear nerve

Question 6

investigations

Answer 6

1 bloods
-high alk phos
-Ca & PO4(3-) normal
2 bone radiographs
-enlarged, deformed bones
-lack of distinction between cortex & medulla
-enlargement of frontal & occipital areas
3 bone scan to assess extent of skeletal involvement
4 resorption markers for monitoring disease activity