An Overview of Paget's Disease of Bone

Symptoms, Causes, Diagnosis, and Treatment

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Paget's disease of bone is the second most common metabolic bone condition behind osteoporosis, causing accelerated bone growth leading to tumors and increased bleeding from fractures. Paget's disease of bone affects one or more bones in the body, but never the entire skeleton.

The body is supposed to break down old bone and replenish it over time. Paget's disease of bone accelerates that process including the regrowth of new bone. The resulting accelerated bone growth leads to abnormal growths, fractures, and deformities. Paget's disease can often go completely without symptoms and inadvertently might be detected only through an X-ray or a surgery performed for a different reason.

Medical authorities don't really know how Paget's disease is acquired or where it started. One theory suggests that it is genetic and began in England. Another theory suggests that it is both genetic and environmental, possibly the result of a virus affecting patients who are genetically sensitive.

Symptoms

Paget's disease of bone might not have any symptoms at all. Most patients never complain and only through diagnostic tests that are looking for other medical conditions do doctors discover the disease.

However, there are patients who have complaints from Paget's disease. These include:

  • Pain in the hips, legs, arms, or headaches
  • Hearing loss
  • Tingling
  • Numbness
  • Weakness in the arms or legs
  • Osteoarthritis
  • Bowing or deformity of the legs or arms
  • Growths or deformity of the skull

Anytime a person has a new onset of pain or weakness in an arm or leg, he/she should make an appointment with a doctor or healthcare professional for an evaluation.

Causes

No one knows exactly what causes Paget's disease of bone.

The most common current working theory is that Paget's disease is a congenital condition with an environmental trigger.

The genetic component is thought to make the patient vulnerable to the disease while the environmental trigger causes the disease to affect the patient. Another theory is that the disease is caused entirely by a virus, although that is a less popular opinion.

Paget's disease of bone is the second most common metabolic bone condition, possibly affecting about 3 percent of the population in areas where it is found. Only osteoporosis is more prevalent.

There is a hereditary component and Paget's disease of bone is more common for people of English, Scottish, and Greek origin. It is a bit more common in men than women and is rarely diagnosed before the age of 50.

The incidence of Paget's disease of bone has been decreasing since the development of vaccines for certain types of viruses, including measles.

Diagnosis

Many patients are diagnosed simply because they were getting a diagnostic test for some other reason. If you are having symptoms, your doctor will most likely order X-rays and could order a bone scan, also known as bone scintigraphy, to look for growths and tumors caused by the disease.

Your doctor may order a lab test to determine the levels of alkaline phosphatase in your blood. Elevated levels indicate the active presence of Paget's disease of bone.

Treatment

Depending on symptoms, treatment ranges from a wait-and-see approach to the use of bisphosphonates, the same class of medications used for the treatment of osteoporosis. Your doctor will likely order treatment if you are experiencing pain or another discomfort.

Also, if you have elevated alkaline phosphatase levels, your doctor might suggest treatment if the location of the bone growth is in a sensitive area.

If symptoms are severe enough, surgery might be indicated to correct areas where bone growth is encroaching on other functions.

Coping

There is no cure for Paget's disease of bone. Your doctor may prescribe treatment to manage the condition or you might be able to continue without changes. Many patients with Paget's disease of bone live their entire lives without knowing they have the condition. Patients with the active disease, even without symptoms, could be more susceptible to fractures and the disease can cause increased bleeding if a bone is broken or if surgery is necessary.

It is important to reduce chances for falling by modifying the home environment to reduce risk, and by getting plenty of exercise focusing on strength, balance, and mobility. Improve the strength of your bones by eating a proper diet including plenty of calcium and vitamin D.

Only about 1 percent of patients with this condition develop bone cancer, but it is important to maintain surveillance with your doctor after a diagnosis of Paget's disease of bone.

A Word From Verywell

Paget's disease of bone is a common condition that many people have for years and don't realize. You may have been given a diagnosis of Paget's disease of bone and haven't had any symptoms. There's no reason to think you might suddenly have more issues in light of your diagnosis. If your doctor discovered the disease through a blood test or X-ray and feels that treatment is necessary, consider what's right for you. Don't be afraid to seek a second opinion if you're not sure. Your doctor may be concerned about bone growth affecting other areas and just wants to assure that you remain symptom-free.

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Article Sources
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