What is Paget's Disease of Bone?
Paget's disease of bone is a condition characterized by impairment of the body's normal bone recycling process, resulting in the formation of soft or misshapen bones that can be easily fractured. It is a chronic bone disorder that commonly affects the pelvis, skull, spine, and leg bones.
Causes of Paget's Disease of Bone
Although the cause of Paget's disease of bone is unclear, a combination of environmental and genetic factors play a role in its development. Some of the factors that can increase your risk for Paget's disease of bone include:
- Advanced Age: People older than 50 years are more likely to develop this disease.
- Gender: Men are at a higher risk of developing Paget’s disease.
- Family History: You are at a higher risk if someone in your family is diagnosed with Paget's disease of bone.
- Environmental Factors: Some studies suggest that certain environmental exposures may play a role in the development of Paget's disease.
Symptoms of Paget's Disease of Bone
Most persons with Paget's disease of bone have no symptoms. When symptoms are present, the most common complaints include:
- Bone pain
- Headaches and hearing loss when the skull is affected
- Leg or arm pain due to pressure on the nerves if the spine is affected
- Hip pain, if Paget's disease affects the pelvis or thighbone
- Damage to joint cartilage, which may lead to arthritis
Diagnosis of Paget's Disease of Bone
Your doctor will review your medical history and symptoms and conduct a physical examination. The following diagnostic tests may be ordered:
- X-rays: This study uses electromagnetic beams to produce images of the bones and can detect fractures.
- Bone Scan: This study uses a radioactive substance to detect any damage to the bones.
- Alkaline Phosphatase Blood Test: This test is used to measure the amount of alkaline phosphatase (ALP) in your blood. A high ALP level is due to the high bone turnover rate that occurs in Paget’s disease.
Treatment for Paget's Disease of Bone
Treatments for Paget’s disease of bone include:
Medications
Paget's disease is treated with a variety of medications. Bisphosphonates are the most common type. These are normally administered through venous injection. They can also be taken orally; however, they may cause stomach irritation.
Surgery
Surgery may be required to treat the following complications of Paget's disease:
- Bone fractures
- Malalignment or deformity of the bone
- Degenerative joint disease
- Nerve impingement
Procedures for Paget’s disease of bone include:
- Internal fixation: This method can be used to treat disease-related fractures of the bone. Internal fixation involves repositioning bone fragments to their normal alignment before holding them in place with screws, wires, pins, or metal plates affixed to the outside of the bone.
- Osteotomy: An osteotomy can help reduce pain and restore alignment to weight-bearing joints affected by Paget’s disease, especially the knee and hip. During this procedure, your doctor removes a wedge of bone near the damaged joint in order to shift weight onto a healthier part of the joint.
- Total joint replacement: During this procedure, parts of the damaged joint are removed and replaced with a prosthesis made of metal, plastic, or ceramic. The prosthesis is made to replicate the movement of a normal, healthy joint.
Prevention
Although most people with Paget's Disease cannot avoid the condition, exercise can help maintain skeletal health, avoid weight gain to reduce pressure on the joints and bones, and promote joint mobility.
