Pagets disease

Question 1

Define Pagets disease of the bone

Answer 1

Bone disorder characterised by focal areas of bone remodelling-resulting in overgrowth of poorly organised bone

can lead to deformities, altered joints, compression, p

can involve 1 bone (25%) or several (75%)

Question 2

Aetiology and risk factors of Pagets disease of the bone

Answer 2

Unkown, but suggested to be part autosomal dominant with variable penetrance
Split in 3 phases-1 with large amounts of osteoclast activity, 1 with activity of both, and 1 with bigger activity of osteoblast
vascularity of bone causes the pain

can involve 1 bone (25%)-usually femur or several (75%)-usually femur, skill, tibia, pelvis

Risk factors
BIG FHx
Age above 55
Men

Question 3

Epidiemology of Pagets disease of the bone

Answer 3

2nd most common bone problem after Osteoporosis
Usually sporadic
about 2.5% and 1.6% of men and women (respectively) above 55

Question 4

Signs and Sx of Pagets disease of the bone

Answer 4

Asympto is common

can involve 1 bone (25%)-usually femur or several (75%)-usually femur, skill, tibia, pelvis

Pain in Bone(s) with microfractures
Boney deformities (like frontal bossing, enlargement of mandible)

very common-warm patch where the bone is remodelling

Hearing loss as ear canal is compressed by bone

Loosening teeth

Question 5

Investigations of Pagets disease of the bone

Answer 5

Plain Xray will be the fastest way-long bones affected
complete trauma unusual

Bone scan (scintillogram)-area of high uptake

AlkPhos-can be very high/
Bone specific AlkP-high
LFT normal
Calcium normal. vit D normal