Paget's disease of bone

Question 1

what is paget’s disease of bone

Answer 1

increased bone turnover in one of multiple bones
increased bone resorption and abnormal osteoclast activity -> results in rapid increased in bone formation by osteoblasts. structure of bone is disorganised and mechanically weaker -> liable to pathological fracture or deformity

4% prevalence in over 40s!!!

Question 2

most common bones

Answer 2

lumbosacral spine
pelvis
skull
femur
tibia

Question 3

presentation

Answer 3

commonly asymptomatic -> incidentally finding of raised alk phos or abnormality on xray

bone pain
deformity
pathological fractures

Question 4

ix

Answer 4

raised alk phos

xray

Question 5

2 signs on xray

Answer 5

blade of grass lesion (v shaped pattern betwen health and diseased long bones)
cotton wool pattern in skull

Question 6

increased risk of

Answer 6

osteosarcoma

Question 7

drug rx

Answer 7

simple analgesics for pain

IV zolendronic acid (only if symptomatic!). many ppl are asymptomatic and so don’t need any rx