Paget's Disease Of The Bone Flashcards
What is Paget’s disease?
It is defined as a condition in which there is increased, uncontrolled bone turnover
What is the pathophysiology of Paget’s disease of the bone?
There is increased bone formation and reabsorption due to excessive osteoclast and osteoblast activity
This excessive turnover is uncoordinated, leading to patchy areas of high density (sclerosis) and low density (lysis)
Ultimately, this results in enlarged and misshapen bones.
Which four bones tend to be affected by Paget’s disease of the bone?
Skull
Spine
Pelvis
Proximal long bones of the lower extremities
What four risk factors are associated with Paget’s disease of the bone?
Older Age
Male Gender
Family History
Northern Latitude
What are the three clinical features of Paget’s disease of the bone?
Bone Pain
Bone Deformity
Pathological Fractures
What are the three investigations used to diagnose Paget’s disease of the bone?
Blood Tests
X-Ray Scans
Isotope Bone Scans
What three blood test results indicate Paget’s disease of the bone?
Increased ALP Levels
Normal Calcium Levels
Normal Phosphate Levels
What are the five features of Paget’s disease of the bone on x-ray scans?
Bone Enlargement & Deformity
Osteoporosis Circumscripta
Skull Cotton Wool Appearance
Thickened Skull Vault
Long Bone V-Shaped Defects
What is osteoporosis circumscripta?
It is defined as well defined osteolytic lesions that appear less dense compared with normal bone
What are cotton wool spots?
They are defined as poorly defined patchy areas of sclerosis and lysis
What are V-shaped defects?
They are defined as V-shaped osteolytic bone lesions surrounded by healthy bone
What is the feature of Paget’s disease of the bone on isotope bone scans?
There is increased uptake at the site of active bone lesions – usually skull, spine, asymmetrical pelvis and proximal long bones
What are the four management indications of Paget’s disease of the bone?
Bone Pain
Skull/Long Bone Deformity
Pathological Fractures
Peri-Articular Involvement
What is the pharmacological management option of Paget’s disease of the bone?
Bisphosphonate Drugs
When are bisphosphonate drugs used to manage Paget’s disease of the bone?
They are the first line pharmacological management option
