What Is Paget’s disease of Bone?
Paget’s disease is a chronic disorder that can result in enlarged and misshapen bones. The excessive breakdown and formation of bone tissue causes affected bone to weaken—resulting in bone pain, misshapen bones, fractures, and arthritis in the joints near the affected bones.
What causes Paget’s disease?
The cause of Paget’s disease is unknown. It does appear to be, at least partially, due to heredity, perhaps when activated by exposure to a virus.
What are the main symptoms and signs of Paget’s?
- Pain may develop directly from a bone affected by the Paget disease, or more often, from complications related to the presence of abnormal bone. Examples of complications include arthritis (when bones near a joint are affected) and numbness or weakness (due to pressure from a bone on a nerve).
- Abnormal bone growth may cause visible deformities, particularly in the arms, legs, skull, and clavicle. If the leg is affected, there can be bowing of the leg, which can cause a limp or back or joint pain.
- The abnormal bone of Paget disease is more likely to fracture when exposed to weight-bearing stresses.
- The risk of developing tumors of the bone is increased in people with Paget disease.
How do we treat Paget’s disease?
The goal of treatment is to relieve bone pain and prevent progression of the disease. Several bisphosphonates are currently available to treat Paget’s disease. Calcitonin is a naturally occurring hormone made by the thyroid gland. The medication may be appropriate for certain patients but is less effective than bisphosphonates and seldom used.
Medical therapy before surgery helps decrease bleeding and other complications. Patients who are having surgery should discuss pretreatment with their doctor. Surgery may be advised for three major complications of Paget’s disease:
- Fractures. Surgery may allow fractures to heal in better position.
- Severe degenerative arthritis. Hip or knee replacement may be considered if disability is severe and medication and physical therapy are no longer helpful.
- Bone deformity. Cutting and realigning pagetic bone may reduce the pain in weight-bearing joints, especially the knees.
- Women age 50 and older and men age 70 and older should get 1,200 mg of calcium and at least 600 IU of vitamin D every day to maintain a healthy skeleton.
- Exercise is important because it helps preserve skeletal health, prevent weight gain, and maintain joint mobility.
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