What are the other Names for this Condition? (Also known as/Synonyms)

• Osseous Paget’s Disease
• Osteitis Deformans
• Paget Disease - Bone

What is Paget’s Disease of the Bone? (Definition/Background Information)

• Paget’s Disease of the Bone is a chronic disorder that disturbs the normal process of breaking down and remodeling of bones in the body
• It affects the rate at which the old bone is broken down and new bone is formed, which is usually enlarged and deformed. The new bone is also very fragile and weak, with increased susceptibility to fractures
• Paget’s Disease of the Bone is generally seen in men over 40 years. The common signs and symptoms of the condition are bone pain and fractures. Bone cancer can arise in very rare cases
• Bisphosphonates are given to treat Paget’s Disease of the Bone. There is no effective method to prevent this bone disorder. The disease and the symptoms can be controlled with proper diagnosis and treatment

Who gets Paget’s Disease of the Bone? (Age and Sex Distribution)

• Paget’s Disease of the Bone usually affects men older than 40 years of age
• The condition is observed worldwide; no specific race or ethnicity is affected. However, individuals of Anglo-Saxon origin seem to be affected more than others

What are the Risk Factors for Paget’s Disease of the Bone? (Predisposing Factors)

Risk factors associated with Paget’s Disease of the Bone are:

• Age: Individuals over the age of 40 years
• Gender: Men are more easily affected than women
• Race: People of Anglo-Saxon descent
• Family history: Those having a family member with Paget’s Disease

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Paget’s Disease of the Bone? (Etiology)

• The bone, being a living tissue, is always engaged in a continuous process of renewal and remodeling, through which old bone is removed and replaced by a new one
• When an individual is affected by Paget’s Disease of the Bone, the old bones start breaking up at a faster rate than the rate at which new ones are formed
• Over a period of time, the body starts building new bones at a faster rate to replace the old ones. This increased rate of production causes the development of new bones that are weak and fragile, leading to bone pain, fractures, and deformities

The exact cause for Paget’s Disease of the Bone is still not known. Some of the possible causes may include:

• Genetic and hereditary factors: It is believed that several genes are related to this disorder that could cause the condition
• Viral infection in the bone that has infected the patient at a much earlier period

What are the Signs and Symptoms of Paget’s Disease of the Bone?

The signs and symptoms displayed by Paget's Disease of the Bone could include:

• Bone pain
• Deformed bones, causing
  • Bowed legs
  • Enlarged skull
  • Enlarged hips
  • Curved backbone
• Easy fractures
• Headache, dizziness
• Vision and hearing defects
• Leg pain
• Numbness
• Weakness
• Reduced height
• Warm skin over the affected bone

How is Paget’s Disease of the Bone Diagnosed?

The diagnosis of Paget’s Disease of the Bone may include:

• A thorough physical examination along with a complete evaluation of medical history
• Imaging tests:
  • X-rays:  X-ray images of the bone reveal areas of bone reabsorption, enlargement of the bone, and other deformities
  • Bone scan: Radioactive material inserted into the body to light up the scan images
• Lab tests: Elevated levels of alkaline phosphate in blood and increased amount of hydroxyproline in urine can help confirm Paget’s Disease of the Bone
• Biopsy of bone: A bone sample is sent to a pathology lab for examination under a microscope. The pathologist examines the biopsy sample which can help make a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Paget’s Disease of the Bone?

The possible complications relating to Paget’s Disease of the Bone are:

• Increased susceptibility to fractures due to fragility of bones
• Osteoarthritis: Deformation of the bone causes additional stress on the neighboring joints, leading to osteoarthritis
• Heart failure: Paget’s Disease forces the heart to work more and makes it harder to pump blood to the affected areas. This increased workload of the heart may lead to a heart failure
• Bone cancer: In some very rare cases, bone cancer may develop
• Deafness and vision loss: Occurs when the condition attacks the skull
• Spinal stenosis: It is the narrowing of the spinal column that leads to an increased pressure on the spinal cord
• Kidney stones: Kidney stones are common in patients affected by Paget’s Disease of the Bone

How is Paget’s Disease of the Bone Treated?

The treatment of Paget’s Disease of the Bone involves:

• Use of bisphosphonates: These are administered either orally or through injections
• When individuals are allergic to bisphosphonates, calcitonin  is recommended through injection, which helps in calcium regulation and bone metabolism

In rare cases, the physician will recommend a surgery to:

• Heal a fracture
• Replace a joint
• Realign deformed bones
• Reduce pressure on the nerves

How can Paget’s Disease of the Bone be Prevented?

Paget’s Disease of the Bone cannot be prevented. The associated complications may be reduced by adopting the following measures, namely:

• Taking medications regularly
• Maintaining body weight
• Doing gentle exercises that do not put pressure on the bones

What is the Prognosis of Paget’s Disease of the Bone? (Outcomes/Resolutions)

• Paget’s Disease of the Bone symptoms can be controlled generally with a proper diagnosis and treatment using medications
• In rare cases, the affected individuals may develop cancer of the bone
• In certain cases, surgery is warranted for correcting bony deformities

Additional and Relevant Useful Information for Paget’s Disease of the Bone:

The overall prevalence and severity of Paget’s Disease are decreasing; the cause of these changes is unclear.