Pagets disease

Question 1

defintion

Answer 1

chronic disorder causing thickened, brittle and misshapen bone

Question 2

aetiology

Answer 2

thought to be caused by paramyxovirus (measles)

Question 3

pathophysiology

Answer 3

increased osteoclast activity causes increased osteoblastic activity to attempt to counteract the excessive bone destruction and resorption, however, the bone that the osteoblasts lay down is thick brittle and off the incorrect shape and size

Question 4

commonly affected bones

Answer 4

pelvis, femur, skull and tibia

Question 5

presentation

Answer 5

most commonly asymptomatic and an incidental finding due to elevated serum ALP or on X-raying for other reason

Question 6

can cause

Answer 6

osteoarthritis, pathological fractures and pain

Question 7

diagnosis

Answer 7

calcium and phosphorous normal but ALP elevated

Question 8

x-ray shows

Answer 8

enlarged thickened lytic bone on x-ray

Question 9

bone scans show

Answer 9

marked increase in uptake in effected bone

Question 10

management

Answer 10

oral or iv biphospahonates

Question 11

oral biphsphophonate used

Answer 11

risodrenate

Question 12

iv biphosphonate

Answer 12

zoledronic acid