Make no bones about it, our skeletal structure has a lot of work to do on a daily basis, and when its activity becomes compromised, many problems can arise. Among the chronic bone diseases is osteitis deformans, more commonly known as Paget’s disease. This is characterized by the disorder of the normal bone remodeling process.
When processes are functioning normally in our bones, there is a rhythm of new bone being laid down to replace old bone. This synchronized relationship, known as remodeling, is necessary to keep the calcium levels at an optimum in our blood.
When Paget’s disease presents, this process is upset and does not allow for the fluidity of synchronization of old bone being replaced by new bone. As a result, the bone that is formed becomes enlarged, brittle, and prone to fractures.
There is no clear evidence as to the causes behind this disease, but it is estimated that one percent of adults in the U.S. have been afflicted by this condition. A rare form exists in children known as juvenile Paget’s disease. Some people are genetically predisposed to developing this disease.
Paget’s disease commonly goes unnoticed by the patient, as typically symptoms do not develop. It is usually discovered when x-rays are conducted for other purposes. Down the road, however, this disease can cause bone pain, deformity, fractures, and arthritis. Bones most commonly affected by Paget’s include the spine, the femur, the pelvis, the collar bone, the upper arm, and the skull.
When symptoms do develop, it depends upon the bones affected and the severity of the disease. When bones become enlarged, it can pinch nearby nerves, causing numbness and/or tingling sensations. The legs can begin to bow. Hips and knees can become stiff and painful, causing one to limp. When the skull is affected, one may notice vision disturbances, hearing loss, or headaches. If the disease becomes widespread, it can tax the heart muscle and contribute to congestive heart failure.
In addition to being diagnosed via x-ray technologies, it can also be detected through bone scans, an MRI scan, or a CT scan. There is also an enzyme within the bloodstream that becomes elevated when Paget’s disease is present. This enzyme is called alkaline phosphatase. A blood test called serum alkaline phosphatase, or SAP, can provide evidence as to Paget’s disease. Since the bone scan provides a grand visualization of the entire skeleton, it is very helpful to determine the extent of the disease in the patient’s body.
Treatment measures are directed towards controlling this disease and managing its resulting complications. Bone pain may require certain pain-relieving medications. Bone deformities may require supports such as heel lifts are specific shoes. In the cases of damaged joints, fractures, severe deformities in the bone, and pinched nerves from over-enlarged bones, surgical procedures may be necessary.
In the long term, the outlook for those afflicted with Paget’s disease is good, especially if treatment is administered before major changes affect the bones. While the treatments can control and manage this disease, they do not cure it. This disease was named after Sir James Paget, an English surgeon who described this condition back in 1877.
(Information for this article was found at http://www.medicinenet.com/pagets_disease/article.htm)
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