Paget’s disease of bone
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Paget’s disease of bone, also referred to as osteitis deformans, is a chronic and uncommon bone condition characterized by abnormal and disproportionate bone remodeling, involving both excessive bone resorption and formation. With time, the bones affected by Paget’s disease can become misshapen and weakened, leading to increased susceptibility to fractures. The bones that are typically impacted include the pelvis, skull, spine, and legs, among others.
Paget’s disease accelerates the process of bone regeneration beyond normal rates, resulting in the formation of new bone tissue that is less structured and more fragile than healthy bone. This can cause bone pain, deformities, and a higher risk of fractures. If Paget’s disease affects a joint, it can result in the development of arthritis in that area.
Age and the family history of the condition both increases the likelihood of Paget’s disease of the bones. However, the disease has been less common over the past few years and less severe when it develops. Broken bones, hearing loss, and spinal nerve compression are examples of complications.
The primary therapy involves bisphosphonates, which are drugs used to rebuild bones that have been weakened by osteoporosis. In the event of complications, surgery can be required.
Symptoms
Many people are unaware that they have Paget’s disease of the bones, which can be asymptomatic or present with mild symptoms. When symptoms do occur, bone pain is the most common complaint. Symptoms of Paget’s disease can resemble those of other bone conditions, such as arthritis.
The symptoms of Paget’s disease of the bone vary based on which bones are affected, and if left untreated, Paget’s disease often worsens gradually over time. Bone Paget’s disease symptoms and warning indicators might include:
- Skull: Hearing loss or headaches can be brought on by an excessive development of bone in the skull.
- Spine: Compressed nerve roots can occur if the spine is affected. An arm or leg may experience discomfort, tingling, or numbness as a result. In advanced cases of Paget’s disease of the bones, various types of bone deformities can occur.
- Pelvis: Hip pain may be brought on by Paget’s disease of the pelvic bone.
- Leg: The patient may become bowlegged as the bones deteriorate and perhaps bend. Osteoarthritis in the knee or hip may result from the legs’ enlarged and deformed bones, which can increase the stress on the surrounding joints.
It is important to seek medical attention if you experience any bone or joint pain, tingling or weakness in your extremities, bone deformities, hearing loss, or headaches, as these could be symptoms of Paget’s disease of the bones.
Causes
The cause of Paget’s disease of the bones is currently unknown, although researchers suggest that a combination of genetic and environmental factors may play a role in its development. Several genes have been linked to the condition. Additionally, there are some hypotheses that propose the possibility of Paget’s disease of the bones being caused by a viral infection in the bone cells.
Risk factors
Factors that can increase your risk of Paget’s disease of bone include:
- Age: The condition most frequently affect people over 50.
- Family history: Individuals with a family history of Paget’s disease of the bones may have a higher risk of developing the condition.
- Gender: Males are affected more frequently than women.
- Race: England, Scotland, central Europe, Greece, and countries where European immigrants have settled, Paget’s disease of the bone is more prevalent.
Diagnosis
Paget’s disease of the bone frequently has no symptoms or have minor symptoms, it is frequently discovered accidentally or by chance after healthcare providers have performed an X-ray or blood test for another reason.
- Physical examination: Healthcare provider will conduct an assessment to the body that cause pain.
Imaging test and blood test may be recommended to confirm the diagnosis of Paget’s disease of bone.
- Imaging tests: Changes in bone could be identified by:
- X-rays: X-ray scans of the bones can reveal areas of bone breakdown, bone enlargement and disease-specific deformities, including the bowing of your long bones.
- Bone scan: Healthcare professionals may perform bone scans to determine the severity of the disease and to see which bones are affected. A radioactive substance is safely injected into the vein during a bone scan. Once inside the bones, the substance causes portions of the bone affected by Paget’s disease to look “bright” on the scan images of the bones.
- Blood test: Elevated levels of alkaline phosphatase in the blood may indicate the presence of Paget’s disease of the bones, and this blood test is often the first indicator that prompts healthcare providers to consider a diagnosis of the condition.
Treatment
In cases where Paget’s disease of the bones is asymptomatic, treatment may not be necessary. However, if the condition is active and is affecting high-risk areas such as the skull or spine, indicated by an elevated alkaline phosphatase level, doctors may recommend treatment to prevent potential complications, even if the patient is not experiencing symptoms.
- Medications: The most popular form of treatment for Paget’s disease of the bones is osteoporosis medication, or bisphosphonates. Bisphosphonates can also be taken orally but are commonly administered via injection into a vein. Orally administered bisphosphonates are often well tolerated but can cause stomach discomfort.
Bisphosphonate therapy has been rarely associated with significant joint, bone, or muscular pain that may persist even after the drug is stopped. Moreover, bisphosphonates can raise the risk of a rare condition known as a section of jawbone die and deterioration, which is typically linked to current dental disease or oral surgery.
A calcitonin, a naturally occurring hormone involved in calcium control and bone metabolism, may be prescribed by a doctor if a patient cannot tolerate bisphosphonates. Patients can self-administer the medication calcitonin by injection or nasal spray. An injection site irritation, facial flushing, and nausea are possible side effects.
- Surgery: The complications of Paget’s disease of the bone may require surgery to correct or improve. Surgical procedures can correct deformed bones, replace damaged knees or hips joints, or help bone fractures heal more effectively.
Paget’s disease of the bones usually result in the body producing an excessive number of blood vessels in the damaged bones, raising the possibility of significant blood loss after surgery. If a patient with Paget’s disease of the bones is scheduled for surgery involving the affected bones, their healthcare provider may prescribe medication to reduce the activity of the condition. This can help prevent excessive blood loss during the procedure.
