Paget's Disease of Bone or Osteoarthritis

Two different conditions that share symptoms

Paget’s disease of bone and osteoarthritis are completely different disorders that share some of the same symptoms: namely, joint pain and bone pain.

  • What are the differences and similarities between Paget’s disease of bone and osteoarthritis?
  • How can Paget’s disease of bone cause osteoarthritis?
  • What are the available treatments?
Rheumatology consultation, doctor examining a patients shoulder
James MyhreBSIP / Universal Images Group / Getty Images

What Is Paget’s Disease of Bone?

Paget’s disease of bone is a chronic disorder that can result in enlarged and misshapen bones. The excessive breakdown and formation of bone tissue cause the affected bone to weaken, resulting in pain, misshapen bones, fractures, and other bone and joint problems, including osteoarthritis. Paget’s disease typically is localized, affecting just one or a few bones, as opposed to osteoporosis, for example, which affects all the bones in the body. Although Paget’s disease and osteoporosis can occur in the same patient, they are also completely different disorders. Scientists do not know for sure what causes Paget’s disease.

What Is Osteoarthritis?

Osteoarthritis is a condition that causes changes in cartilage, the elastic tissue that cushions the joints. Healthy cartilage allows bones to glide over one another while absorbing energy from the shock of physical movement. In osteoarthritis, the surface layer of cartilage breaks down and wears away. This allows bones under the cartilage to rub together, causing pain, swelling, and loss of motion of the joint.

Distinguishing Between Paget’s Disease and Osteoarthritis

Not everyone with Paget’s disease will develop osteoarthritis. Among those who have both, some may have osteoarthritis caused by the Paget’s disease, while others will simply have two unrelated conditions.

Both Paget’s disease and osteoarthritis can cause joint and bone pain. In people with both conditions, joint and bone pain can occur in the same areas of the body. This can sometimes make it difficult for doctors to tell which condition is causing the pain.

No single test can distinguish osteoarthritis from Paget's disease. The diagnosis of osteoarthritis in a person with Paget’s disease may include:

  • Blood tests
  • X-rays
  • Examination of joint fluid

Blood and urine tests may also be used to help find out if something other than Paget’s disease is causing arthritis.

The bone changes revealed by X-ray images help doctors diagnose both osteoarthritis and Paget’s disease. However, in people who have both conditions in the same area of the body, it can be difficult to distinguish between the two. For this reason, the judgment of the patient’s doctor is important for accurate diagnosis and effective treatment.

How Paget’s Disease Can Cause Osteoarthritis

Although they are different conditions, there is a link between Paget’s disease and osteoarthritis. The changes that occur in bones affected by Paget’s disease can also affect the function of nearby joints. As a result, people with Paget’s disease frequently have osteoarthritis. Paget’s disease can cause osteoarthritis when it:

  • Changes the shape of bones under the cartilage of the joint
  • Causes long bones (such as the thigh or leg) to bow and bend, placing excess stress on the joints
  • Causes changes in the normal curvature of the spine
  • Softens the pelvis, affecting the hip joint


The treatment strategies for Paget’s disease and osteoarthritis are quite different, so it is important to distinguish between the two when making treatment-related decisions. For example, people with both disorders who get good results from their Paget’s disease treatment may continue to experience arthritis-related pain. Correctly identifying osteoarthritis as the source of pain is critical to the selection of effective treatments.

The goal of osteoarthritis treatment is to improve joint function and control pain and swelling. Treatment approaches include:

  • Exercise
  • Weight control
  • Rest
  • Joint care
  • Prescription and over-the-counter medicines
  • Pain-relief techniques
  • Alternative therapies such as acupuncture and dietary supplements
  • Surgery on the affected joint (in some cases)

The goal of Paget’s disease treatment is to relieve pain and control the progress of the disorder. Treatment strategies include:

  • The use of prescription drugs approved for Paget’s disease (despite their marked differences, several medications for Paget’s disease are also used to treat osteoporosis)
  • Over-the-counter pain medicines
  • Appropriate forms of exercise
  • Surgery on the affected bone or joint (in some cases)

Because effective therapies are available for both Paget’s disease and osteoarthritis, the results of the combination of the two disorders need not be severe. This is particularly true when treatment for Paget’s disease begins before major complications have developed.

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  • Paget’s Disease of Bone and Osteoarthritis: Different Yet Related (edited), NIAMS, Oct. 2005