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Monthly Archives: June 2016

Paget’s Disease of bone

Paget's disease of bone

 

Paget’s disease of bone is a chronic condition that causes abnormal enlargement of the bone, causing the bone to thicken and weaken. The most common effected sites include the skull, spine, pelvis and the long bones of the upper arms and legs, however any part of the skeleton can be affected including the heel bone. Paget’s disease typically affects people over the age of 50 and tends to affect men slightly more than women.

Symptoms:

Symptoms of Paget’s disease may include:

  • Stiffness in joints
  • Constant fatigue
  • Aching in the bones
  • Pains becoming worse during the night
  • Bone shape deforming such as bowing legs
  • Affected areas are significantly warmer
  • Headaches and increasing head size (if the skull is affected)
  • Bone Fractures

Who is most likely to get Paget’s disease?

Although the cause of Paget’s disease is not quite known, risk factor seem to include:

  • Age – Paget’s disease is more common with increasing in age
  • Race – Those with Anglo-Celtic background are more likely to develop Paget’s disease of the bone, particularly those living in Britain, Australia, New Zealand and Western Europe
  • Genetics – In around 30% of cases there is a family history of the disease

Healthy bone tissue is maintained by cells known as osteoblasts (that build new bone) and osteoclasts (that remove old bone). In a person with Paget’s disease, the balance between these two groups of cells is disturbed with the osteoblasts becoming overactive and producing too much bone, leading to enlargement. This unusual growth means that the new bone tissue is weak and unstable.

Symptoms of Paget’s disease

Many people who have Paget’s disease do not realise as they only mild if any symptoms of the disease.

Depending on how severe the condition is, symptoms may include:

  • Stiffness in the joints
  • Painful aching in the bones
  • Aches and pains becoming more acute during the night
  • The bone appears bent or thickened
  • The affected site is significantly warmer than the rest of the body
  • Bowing of the leg bones (if the legs are affected)
  • Headache and increased head size if the skull is involved
  • Bone fractures

 

Complications of Paget’s disease

Paget’s disease can lead to further complications, such as:

  • Osteoarthritis in joints formed by affected bones
  • Broken bones that may occur with a fall or spontaneously due to the new bone growth being weak and fragile
  • Inner ear conditions such as tinnitus (ringing in the ears) or vertigo (a type of dizziness)
  • Deafness caused by pressure on the auditory nerves
  • Increased workload on the heart due to an increased number of blood vessels in the affected bones which leads to increased blood flow through the bones.
  • Numbness or paralysis caused by deteriorating vertebrae pinching the nerves in the spinal cord
  • Bone cancer of the affected area can occur, but this is rare

Diagnosis of Paget’s disease:

As most of the sufferers of Paget’s disease have no symptoms, the condition is often diagnosed when investigating another problem, often found during x-rays taken. The diagnosis of Paget’s disease can be confirmed via further x-rays, bone scans or by a blood test showing elevated alkaline phosphatase.

Treatment for Paget’s disease:

There is no cure for Paget’s disease, however symptoms can be helped by:

  • Drugs acting on the bones – such as bisphosphonates, are used to slow the progression of the condition. Bisphosphonates help the body control the bone-building process to stimulate more normal bone growth
  • Non-steroidal and anti-inflammatory drugs to relieve pain
  • Calcium and Vitamin D. It is best to discuss with your doctor as high amounts of calcium in the blood is often present in Paget’s disease and need to be monitored carefully as this can cause other medical problems
  • Surgery may be required to relieve pinched nerves or bone fractures or to replace a badly worn join
  • Exercise will help to maintain skeletal health and mobility in the joints along with strengthening the surrounding muscles. However as bones are weaker and more likely to fracture, certain forms of excursive will be inappropriate for people with Paget’s disease

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