Paget Disease Of Bone: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

The bone condition known as Paget's disrupts your body's natural recycling process, which involves the progressive replacement of old bone tissue with new bone. Bones can become brittle and malformed with age. The most frequently affected areas are the legs, pelvis, cranium, and spine.

Growing older and having family members with the condition raise the chance of Paget's disease of the bones. But during the past few years, the disease has grown less common and, when it does arise, is less severe for reasons that remain unexplained to medical professionals. Broken bones, hearing loss, and pinched nerves in the spine are examples of complications.

The fundamental principle of treatment is the use of bisphosphonates, which are drugs that strengthen bones that have been weakened by osteoporosis. A surgical procedure can be required if problems arise.

Causes  Of Paget Disease Of Bone

It is unknown what causes Paget's disease of the bones. Scientists believe that the condition is caused by a mix of genetic and environmental causes. It seems that having the illness is associated with multiple genes.

Although this notion is debatable, some experts think that Paget's disease of the bone is linked to a viral infection in your bone cells.

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Symptoms Of Paget Disease Of Bone

Most patients with bone-related Paget's disease do not exhibit any symptoms. Bone discomfort is the most prevalent complaint when symptoms appear.

The rapid remodeling that results from this disease's accelerated bone synthesis leads to less organized and weaker bone than normal bone, which can cause bone discomfort, deformities, and fractures.

Your body may be affected by the disease in one or two regions, or it may be extensive. The afflicted body part will determine your symptoms and signs, if any.

• Pelvis-Hip pain may result from Paget's disease, a disorder of the pelvic bone.
• Skull headaches or loss of hearing may result from an overgrowth of bone in the skull.
• Spine: Compression of nerve roots may occur if your spine is impacted. An arm or limb may become painful, tingly, or numb as a result of this.
• Leg: You might become bow-legged as a result of the bones bending as they deteriorate. Leg bones that are enlarged or malformed might place additional strain on neighboring joints, leading to osteoarthritis in your hip or knee.

Also Read: Hip Dysplasia: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Risk Factors  Of Paget Disease Of Bone

The following variables may make you more susceptible to Paget's disease of the bone:

• Age: The condition most commonly affects those over 50.
• Sex: Compared to women, men are impacted more frequently.
• Race: In addition to the countries where European immigrants have resided, Paget's disease of the bones is more prevalent in England, Scotland, central Europe, and Greece. In Asia and Scandinavia, it is rare.
• Family background: You are more likely to get Paget's disease of the bone if you have a family who has the illness.

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Diagnosis  Of Paget Disease Of Bone

Your doctor will evaluate the painful parts of your body during the physical examination. To help with the diagnosis of Paget's disease of the bone, he or she might additionally request blood tests and X-rays.

Imaging examinations

Bone alterations can be observed by:

• X-ray: Often, abnormalities discovered on X-rays taken for unrelated purposes are the first sign of Paget's disease of the bones. Your long bones may bow. X-ray pictures of your bones can reveal areas of bone deterioration, expansion of the bone, and disease-specific abnormalities.
• Bone scan: Your body is injected with radioactive substances for a bone scan. The areas of your bones that are most affected by this substance move there and appear to light up in the scan photos.

Laboratory examinations

A blood test can detect high levels of alkaline phosphatase in the blood, which is typical in patients with Paget's disease of the bone.

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Treatment  Of Paget Disease Of Bone

In the event that you are symptom-free, treatment may not be necessary. Even in the absence of symptoms, your doctor may still advise therapy if the disease is active, as shown by an elevated alkaline phosphatase level, and affects high-risk areas of your body like your spine or skull.

Drugs

The most popular treatment for Paget's disease of the bones is osteoporosis medication, often known as bisphosphonates. Although oral administration is the usual method of administering bisphosphonates, they can also be given intravenously. Although they can irritate the stomach, bisphosphonates are usually well tolerated when taken orally.

Intravenous bisphosphonates that are administered include:

• Zoledronic acid
• Oral bisphosphonates consist of pamidronate
• Risedronate
• Alendronate 

Bisphosphonate therapy has been associated with significant bone, joint, or muscular pain that may not go away when the drug is stopped. Additionally, a rare condition where a portion of the jawbone deteriorates and dies can be made more likely by bisphosphonates. This condition is typically linked to oral surgery or active dental illness.

Surgery

Rarely, surgery may be necessary in order to:

• Helps in the healing of fractures
• Replace joints that are severely impacted by arthritis
• Realign deformed bones
• Reduce the strain on the nerves

In the afflicted bones of Paget's disease of the bone, the body frequently produces an excessive number of blood vessels, raising the possibility of major blood loss after surgery.

Your doctor may recommend medication to lower the activity of Paget's disease of the bone if you have surgery planned that will include damaged bones. This could assist in minimizing blood loss during the procedure.

Also Read: Tuberculosis of Bone & Joints

Complications  Of Paget Disease Of Bone

Bone disease caused by Paget's disease usually advances gradually. For almost everyone, the illness is effectively manageable. Among the potential issues are:

• Deformities and fractures: Bones that are affected are more prone to breaking, and during repair procedures, the additional blood arteries in these malformed bones increase bleeding. Leg bones may flex, which may impair your gait.
• Osteoarthritis: An increased amount of stress on adjacent joints due to malformed bones might result in osteoarthritis.
• Neurological problems: When Paget's disease of the bone affects the spine, skull, or other regions where nerves run through the bone, the overgrowth of bone can compress and destroy the nerve, resulting in pain, tingling, or weakness in the arm or leg, as well as hearing loss.
• Heart failure: Your heart may need to pump blood to the damaged portions of your body more forcefully in severe cases. Heart failure is occasionally a result of this increasing strain.
• Carcinoma of the bones: Of those with Paget's disease of the bone, up to 1% develop bone cancer.

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