Paget's disease is a chronic condition that results in enlarged and deformed bones. Although any bone in the body may be affected, the most common sites are the spine, skull, pelvis, thighs, and lower legs. The disease does not usually spread to other normal bones.
Normal Bone Structure
Paget's disease is caused by a malfunction in bone formation. Normally, bones are constantly being broken down by cells called osteoclasts, and rebuilt by cells called osteoblasts. With Paget's disease, bones are broken down abnormally fast, and new bone replacement is loose and bulky, instead of strong and compact. These poorly formed bones may become weak, and may bend over time.
The exact cause of this bone malformation is unknown, but it is associated with heredity. Some experts believe that Paget's may be triggered early in life by a viral infection.
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for Paget's disease include:
- Family history of Paget's disease, especially in a parent, sibling, or child
- Race: Anglo-Saxon, European
- Age: 40 or older
- In US, residence in northern states
In the early stages, most people have no noticeable symptoms. In later stages, symptoms may include:
- Swelling or deformity of a limb
- Increased head size
- Bowing of a limb
- Curvature of the spine
- Chronic bone pain, especially legs, hips, or spine
- Frequent fractures
- Problems with walking or gait
- Headaches, facial pain, or hearing loss when the skull bones are affected
- Swollen or painful joints due to damaged joint cartilage
- Numbness, tingling, pain, or weakness from pressure on nerves
Depending on the bone site, Paget's disease may result in:
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
Treatment may include:
Medications may include:
Surgery may be required if you have one of the following conditions:
- Bone fracture
- Severe degenerative arthritis
- Bone deformity
- ]]>Calcium]]> , usually about 1,000-1,500 mg per day
- Adequate exposure to sunshine to promote ]]>vitamin D]]> production in the skin (but limit time in the sun to prevent sun burning, wrinkling, and aging)
- Intake of adequate ]]>vitamin D]]> , usually about 400 mg per day (more may be needed in older people)
- ]]>Regular exercise]]> to maintain skeletal health, joint mobility, and normal body weight
- Avoidance of excess mechanical stress on involved bones
- A splint for an area at high risk for fracture
Osteoporosis and Related Bone Diseases National Resource Center
The Paget Foundation
The Arthritis Society
National Institutes of Health Osteoporosis and Related Bone Diseases, National Resource Center website. Available at: http://www.niams.nih.gov/Health_Info/Bone/ . Accessed October 11, 2005.
Questions and answers about Paget's disease of bone. The Paget Foundation website. Available at: http://www.niams.nih.gov/Health_Info/Bone/ . Published 2008. Accessed July 24, 2009.
Schneider D, Hofmann MT, Peterson JA. Diagnosis and treatment of paget's disease of bone. Am Fam Physician . 2002;15;65(10).
Last reviewed November 2009 by ]]>Robert E. Leach, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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