Disease: Paget's Disease of Bone

    Paget's disease facts

    • Paget's disease is a chronic bone disorder.
    • Paget's disease frequently causes no symptoms.
    • Paget's disease can cause pain in the bones or joints, headaches and hearing loss, pressure on nerves, increased head size, bowing of limb, or curvature of spine.
    • Tests used to diagnose Paget's disease include X-rays, blood tests, and bone scanning.
    • Paget's disease can lead to other medical conditions.
    • Medical treatment options include aspirin, other anti-inflammatory medications, pain medications, and medications that slow the rate of bone turnover, decreasing the activity of Paget's disease.
    • Surgical operations may necessary for damaged joints, fractures, severely deformed bones, or when nerves are being pinched by enlarged bone.

    What is Paget's disease?

    Paget's disease is a chronic condition of bone characterized by disorder of the normal bone remodeling process. Normal bone has a balance of forces that act to lay down new bone and take up old bone. This relationship (referred to as "bone remodeling") is essential for maintaining the normal calcium levels in our blood. In bone affected by Paget's disease, the bone remodeling is disturbed and not synchronized. As a result, the bone that is formed is abnormal, enlarged, not as dense, brittle, and prone to breakage (fracture).

    Paget's disease affects older skeletal bone of adults. It's estimated that 1% of adults in the U.S. have Paget's disease. There is also an extremely rare form of Paget's disease in children, referred to as juvenile Paget's disease. Paget's disease is also known as osteitis deformans.

    What causes Paget's disease?

    It is not known what causes Paget's disease. Recently, certain genes have been associated with Paget's disease, including the Sequestrosome 1 gene on chromosome 5. Virus infection may be necessary to trigger Paget's disease in people who have inherited the genetic tendency to develop the condition by having these genes.

    What are Paget's disease symptoms?

    Paget's disease commonly causes no symptoms and is often incidentally noted when X-ray tests are obtained for other reasons. However, Paget's disease can cause bone pain, deformity, fracture, and arthritis. The bone pain of Paget's disease is located in the affected bone. The most common bones affected by Paget's disease include the spine, the thigh bone (femur), the pelvis, the skull, the collarbone (clavicle), and the upper arm bone (humerus).

    The symptoms of Paget's disease depend on the bones affected and the severity of the disease. Enlarged bones can pinch adjacent nerves, causing tingling and numbness. Bowing of the legs can occur. Hip or knee involvement can lead to arthritis, limping, as well as pain and stiffness of the hip or knee. Headache, loss of vision, and hearing loss can occur when bones of the skull are affected. With very widespread Paget's disease, it is possible to develop congestive heart failure due to an increased workload on the heart.

    How is Paget's disease diagnosed?

    Paget's disease is diagnosed based on the X-ray appearance. Paget's disease might also be detected with other imaging tests, such as a bone scan, MRI scan, and CT scan. Alkaline phosphatase, an enzyme that comes from bone, is frequently elevated in the blood of people with Paget's disease as a result of the abnormal bone turnover of actively remodeling bone. This blood test is also referred to as the serum alkaline phosphatase (SAP) and is used to monitor the results of treatment of Paget's disease.

    The bone scan is particularly helpful in determining the extent of the involvement of Paget's disease as it provides an image of the entire skeleton. Bone that is affected by Paget's disease can easily be identified with bone scanning images.

    What is the treatment for Paget's disease?

    The treatment of Paget's disease is directed toward controlling the disease activity and managing its complications. When Paget's disease causes no symptoms and blood testing shows that the level of serum alkaline phosphatase is normal or minimally elevated, no treatment may be necessary. Bone pain can require anti-inflammatory drugs (NSAIDs) or pain-relieving medications. Bone deformity can require supports such as heel lifts or specialized footwear. Surgical operations may be necessary for damaged joints, fractures, severely deformed bones, or when nerves are being pinched by enlarged bone. Prior to undergoing an operation on bone affected by Paget's disease, it is helpful to be treated with medications, such as bisphosphonates or calcitonin (Miacalcin), as this tends to diminish the risk of surgical complications, including bleeding.

    Learn more about: Miacalcin

    The medical treatment of the bone of Paget's disease involves either medications called bisphosphonates or injectable calcitonin. These drugs are also used to treat certain patients with osteoporosis.Bisphosphonates are the mainstay of treatment. There are a number of these available that are taken by mouth, including alendronate (Fosamax), risedronate (Actonel), etidronate (Didronel), and tiludronate (Skelid), and that are administered intravenously, including pamidronate (Aredia) and zoledronate (Reclast). In general, oral bisphosphonates are taken first thing in the morning on an empty stomach with 8 ounces of water. They can cause irritation of the stomach and esophagus. Intravenous bisphosphonates can cause temporary muscle and joint pain but are not associated with irritation of the stomach or esophagus.

    Learn more about: Fosamax | Actonel | Didronel | Skelid | Aredia | Reclast

    What are Paget's disease symptoms?

    Paget's disease commonly causes no symptoms and is often incidentally noted when X-ray tests are obtained for other reasons. However, Paget's disease can cause bone pain, deformity, fracture, and arthritis. The bone pain of Paget's disease is located in the affected bone. The most common bones affected by Paget's disease include the spine, the thigh bone (femur), the pelvis, the skull, the collarbone (clavicle), and the upper arm bone (humerus).

    The symptoms of Paget's disease depend on the bones affected and the severity of the disease. Enlarged bones can pinch adjacent nerves, causing tingling and numbness. Bowing of the legs can occur. Hip or knee involvement can lead to arthritis, limping, as well as pain and stiffness of the hip or knee. Headache, loss of vision, and hearing loss can occur when bones of the skull are affected. With very widespread Paget's disease, it is possible to develop congestive heart failure due to an increased workload on the heart.

    How is Paget's disease diagnosed?

    Paget's disease is diagnosed based on the X-ray appearance. Paget's disease might also be detected with other imaging tests, such as a bone scan, MRI scan, and CT scan. Alkaline phosphatase, an enzyme that comes from bone, is frequently elevated in the blood of people with Paget's disease as a result of the abnormal bone turnover of actively remodeling bone. This blood test is also referred to as the serum alkaline phosphatase (SAP) and is used to monitor the results of treatment of Paget's disease.

    The bone scan is particularly helpful in determining the extent of the involvement of Paget's disease as it provides an image of the entire skeleton. Bone that is affected by Paget's disease can easily be identified with bone scanning images.

    What is the treatment for Paget's disease?

    The treatment of Paget's disease is directed toward controlling the disease activity and managing its complications. When Paget's disease causes no symptoms and blood testing shows that the level of serum alkaline phosphatase is normal or minimally elevated, no treatment may be necessary. Bone pain can require anti-inflammatory drugs (NSAIDs) or pain-relieving medications. Bone deformity can require supports such as heel lifts or specialized footwear. Surgical operations may be necessary for damaged joints, fractures, severely deformed bones, or when nerves are being pinched by enlarged bone. Prior to undergoing an operation on bone affected by Paget's disease, it is helpful to be treated with medications, such as bisphosphonates or calcitonin (Miacalcin), as this tends to diminish the risk of surgical complications, including bleeding.

    Learn more about: Miacalcin

    The medical treatment of the bone of Paget's disease involves either medications called bisphosphonates or injectable calcitonin. These drugs are also used to treat certain patients with osteoporosis.Bisphosphonates are the mainstay of treatment. There are a number of these available that are taken by mouth, including alendronate (Fosamax), risedronate (Actonel), etidronate (Didronel), and tiludronate (Skelid), and that are administered intravenously, including pamidronate (Aredia) and zoledronate (Reclast). In general, oral bisphosphonates are taken first thing in the morning on an empty stomach with 8 ounces of water. They can cause irritation of the stomach and esophagus. Intravenous bisphosphonates can cause temporary muscle and joint pain but are not associated with irritation of the stomach or esophagus.

    Learn more about: Fosamax | Actonel | Didronel | Skelid | Aredia | Reclast

    Source: http://www.rxlist.com

    The treatment of Paget's disease is directed toward controlling the disease activity and managing its complications. When Paget's disease causes no symptoms and blood testing shows that the level of serum alkaline phosphatase is normal or minimally elevated, no treatment may be necessary. Bone pain can require anti-inflammatory drugs (NSAIDs) or pain-relieving medications. Bone deformity can require supports such as heel lifts or specialized footwear. Surgical operations may be necessary for damaged joints, fractures, severely deformed bones, or when nerves are being pinched by enlarged bone. Prior to undergoing an operation on bone affected by Paget's disease, it is helpful to be treated with medications, such as bisphosphonates or calcitonin (Miacalcin), as this tends to diminish the risk of surgical complications, including bleeding.

    Learn more about: Miacalcin

    The medical treatment of the bone of Paget's disease involves either medications called bisphosphonates or injectable calcitonin. These drugs are also used to treat certain patients with osteoporosis.Bisphosphonates are the mainstay of treatment. There are a number of these available that are taken by mouth, including alendronate (Fosamax), risedronate (Actonel), etidronate (Didronel), and tiludronate (Skelid), and that are administered intravenously, including pamidronate (Aredia) and zoledronate (Reclast). In general, oral bisphosphonates are taken first thing in the morning on an empty stomach with 8 ounces of water. They can cause irritation of the stomach and esophagus. Intravenous bisphosphonates can cause temporary muscle and joint pain but are not associated with irritation of the stomach or esophagus.

    Source: http://www.rxlist.com

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