Paget’s Disease of Bone

Paget’s disease of bone occurs in the elderly primarily.  Occasionally young people have this disease.

Paget’s disease involves abnormal regulation and control of bone remodelling and structure.  Excess bone destruction or excess bone formation occur alone or together.  This abnormal bone activity leads to abnormally thin or fragile bone or abnormally thick and deformed bone.

Usually the disease occurs sporadically but can occur in families (genetic inheritance)

The diagnosis is often made incidentally after routine blood test detects an elevated blood bone marker (ALP Level) or via xray of pelvis or femur which is affected by Paget’s disease.

Paget’s disease can occur in  single bone or multiple bones including spine, pelvis, hip bone, femur, shoulder and skull. It occurs as single lesion or multiple.  Often it is asymptomatic but can produce bone pain (even present at night) bone deformity, nerve entrapment or increase in head and deafness.  Increased bone fragility can cause fracture.

Diagnosis

Checking the ALP enzyme level in blood identifies increase bone cell activity.  Plain X-Ray or nuclear bone scan are used to determine which bones affected.

Treatment

Simple pain killer medication or anti-inflammatory can reduce pain.  Specific drug therapy includes oral or intravenous drug therapy with bisphosphonate medication.  Older treatment with calcitonin has also been used.

Surgery to repair fracture or deformity or nerve entrapment may be required.