Paget's Disease

Paget’s disease – Disruption of Bone Renewal/Repair of Normal Bone

Paget’s disease or osteitis deformansis a chronic ailment which disrupts the normal cycle of bone renewal and repair of the normal bone remodelling process. The normal bones strikes a balance to lay down new bone and take up old bone which is known as bone remodelling which is essential in maintaining the normal calcium levels in the blood.

 Bones affected by Paget’s disease tend to get disturbed in bone remodelling and is not synchronized resulting in the bone being abnormal, enlarged and tends to get brittle and vulnerable to fracture. It mainly affects the older bone of adults.

This condition commonly causes no symptoms and is noticed when x-ray tests are done for other ailments.

Paget’s disease can cause pain in the bone which is the most common symptoms that often affects the pelvic, the thigh bone, the skull, the collarbone, the upper arm bone or spine and the pain get worse when lying down.

X-Ray/Bone Scan, MRI/CT Scan

The symptoms of this condition are based on the severity of the affected bones. Enlarged bone ten to pinch adjacent nerves resulting in numbness and tingling and may also lead to bowing of the legs. Hip or knee could lead to arthritis causing limping with pain and stiffness of the knee or hip.

When the bones of the skull get affected, headache, hearing loss and loss of vision may also occur. This condition is diagnosed depending on the x-ray, though it could also be detected with other imaging test like bone scan, CT scan and MRI scan.

Alkaline phosphatase, an enzyme which comes from bone is at times increased in the blood of people with this condition due to the abnormal bone turnover of actively re modelling bone. Besides this, the blood test is also referred to as the serum alkaline phosphatase - SAP, which is used to check the results of Paget’s treatment.

Surgery – Osteoarthritis/Bone Fracture

Bone scan is especially helpful in identifying the extent of the condition since it provides an image of the whole skeleton and the bone that is affected by this condition can be easily determined with bone scanning images.

Paget’s disease can be treated by controlling the disease activity and handle it complications. When this ailment causes no symptoms and the blood testing indicates that the level of serum alkaline phosphatase is normal, no treatment would be needed. Pain in the bone could be relieved with anti-inflammatory drugs or pain relieving medication while bone deformity would need supports like heel lifts or specialized footwear.

For damaged joints, severely deformed bones, fractures or when nerves are pinched due to enlarged bone, surgical operation would be needed. Before undergoing an operation it could be helpful to be treated with medication which could diminish the risk of complication of surgery. Surgery is often done when the disease tends to cause further problems like osteoarthritis or a bone fracture.

In some rare cases, Paget’s disease could also cause bone cancer or heart failure. It is not clear why this condition occurs, but genetic as well as environment factors are believed to be the result of this disease where around 15% of the cases runs in the family.