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Paget's Disease of Bone
Key Points
Key Points
- Paget’s disease of bone (osteitis deformans) is a chronic benign disorder of bone that generally affects one or several bones.
- The abnormal bone structure may be associated with enlarged affected bones and skeletal deformity, particularly in weight-bearing bones.
- Many patients with Paget’s disease of bone are asymptomatic. Bone pain, mild to moderate in intensity and described as deep and aching, is a feature of Paget’s disease of bone, usually developing late rather than early in the disease process, and it is only present in a minority of patients.
- The clinical features and complications of Paget’s disease are closely related, but presentation varies from patient to patient.
- The most common neurological complication of Paget’s disease is hearing loss associated with disease involving the skull.
- Studies of patients with Paget’s disease indicate there is a family history of the disorder, an autosomal dominant transmission pattern, in 5%–40%, with most researchers reporting a 10%–20% incidence.
- Paget’s disease affects both men and women, with an apparent small male predominance. It rarely manifests itself clinically before age 40, and the frequency of the condition increases with advancing age.
- Rates in the United States are estimated to be approximately 2%–3% among individuals older than 55 years.
Diagnosis
...agnosi...
Imaging
...patients with suspected Paget’s disease,...
...patients diagnosed with Paget’s disease, the...
...ochemistr...
...recommends that after radiological diagnosis of...
...toms and Complications of Paget’s Dis...
Treatment
...reatment
...mmended Bisphosphonate Dosing RegimensHav...
...ndication...
...ecommends treatment with a bisphosphona...
...hoice of Medica...
...a single 5-mg dose of IV zoledronate as...
...sessing the Response to Treatmen...
...ere is urgency in the control of symptoms or the d...
...suggests that patients who have osteolytic...
...intaining Remissi...
...suggests that to maximize the duration of re...
...and Retreatment...
...recommends that in patients with increased...
...tic Paget’s Disease
...that amino-terminal propeptide of...
...gement of the Complications of Page...
...aring Loss...
...e ES suggests treatment with a potent...
...oarthritis...
...he ES suggests the use of analgesics as...
...nts with severe osteoarthritis adjacen...
...of Lower Extremity...
...ts treatment with a potent bisphosphonat...
...lysis...
...f paraplegia associated with Paget’s d...
...eoplasms
...ts that patients with osteosarcoma or a gi...
...tive Heart Failure...
...treatment with a bisphosphonate in pat...