Pagets disease of bone

Paget’s disease of bone

What is Paget's disease of bone?
Paget's disease of bone is a chronic bone disease that causes abnormal bone formation and breakdown. As a result, bones are weak, dense, and deformed. It most commonly occurs in older adults (over 50 years of age) and affects bones such as the pelvis, spine, skull, and leg bones.

Causes
- The exact cause is unknown, but it is believed to be genetic. It is more common in families.
- Viruses or infections: Research suggests that viruses may stimulate bone-building cells.

Symptoms
Paget's disease is often asymptomatic initially, but symptoms may include:
- Chronic bone pain (usually associated with abnormal bone growth)
- Bone deformities, such as bow legs or enlarged head
- Brittle bones that are prone to fracture
- In cases of spinal damage, numbness or weakness in the arms and legs may occur. Some individuals may also experience decreased hearing. If the skull bone is damaged,

Diagnosis
A doctor will diagnose using:
1. Bone X-ray – shows thick, deformed, and irregular bone structure.
2. Blood test – Measures elevated alkaline phosphatase (ALP), a sign of abnormal bone formation.
3. Bone scan – Helps assess which bone is affected.

Treatment
The goal of treatment is to reduce bone destruction and prevent complications.
- Bisphosphonates – Mainly used to reduce abnormal bone formation, such as alendronate or zoledronic acid.
- Painkillers – Paracetamol or NSAIDs for pain relief.
- Surgery – In cases of severe fractures or osteoarthritis caused by Paget's disease.
- Follow-up – Periodic ALP tests and bone X-rays.

Should or shouldn't?
Examination and treatment should be performed if:
- Bone pain
- Bone deformity
- Elevated ALP or a risk of fracture.
No treatment is necessary.
*If the patient is asymptomatic If the disease is detected incidentally and ALP is normal, the doctor may choose to monitor the condition only.



Summary
Paget's disease of bone is a chronic bone disease that causes thickening and brittle bones. It is common in older adults. Most patients are asymptomatic, but some patients experience bone pain or deformity. Diagnosis is made through X-rays and blood tests. The primary treatment is bisphosphonates and regular monitoring.