Paget’s Disease

Paget’s Disease of the bone is a chronic medical condition of the skeleton in which bone areas grow abnormally becoming soft while enlarging. The disease may affect any bones, Paget’s Diseaseespecially femur (thigh-bone), spine (vertebrae), humerus (upper arm bone), shins, skull, and pelvis.

In Paget bone disease, osteoblasts (cells, that produce new bones) and osteoclasts (cells that break down old bones) become overactive in certain bone areas, and the turnover rate in such parts increases significantly. The overactive areas enlarge, but are structurally defective and weakened. The causes of Paget’s Disease of the bone aren’t known, but some experts suggest that viral infections are involved.

The disorder generally produces no symptoms. When fatigue and stiff joints occur, they commonly develop subtly and slowly. Bone aches, deformity, or enlargement can occur. Pain in bones can be deep and severe and can worsen at night. Enlarged bones can compress the nerve, adding the aching. In some cases, Pagets Disease of the bone causes progression of painful osteoarthritis in adjacent joints.

Symptoms are different and depend on which bone is affected. The forehead and brows can look more prominent, and the skull can enlarge. Enlarged skull bones may result in loss of hearing by injuring the inner ear (called cochlea); headache, by compressing nerve; and bulging vein on the scalp. The vertebrae can enlarge, buckle, and weaken causing height loss. Damaged vertebrae may cause weakness, numbness, tingling, or sometimes leg paralysis. Individuals with affected legs or hip bones, can take unsteady, short steps, and have bowed legs. The defected bones may break.

Paget’s Disease is frequently diagnosed accidentally when laboratory or x-ray tests are done for other reasons. Also, a doctor may suspect the disorder based on the physical examinations and symptoms. A patient with Paget’s Disease of the bone requires treatment only if symptoms result in discomfort or if the risks of complications including hearing loss, deformity, or arthritis are high.

Nonsteroidal anti-inflammatory medications, such as Aspirin and others as well as analgesics such as Acetaminophen reduce bone pain. If the leg becomes bowed, hill lift may help to walk easier. In some cases, surgery is required to relieve pinched nerves or replace arthritic joints. A bisphosphonate, pamidronate, etidronate, calcitonin, or alendronate, may be taken to slow the development of Paget’s Disease. These medications are prescribed before surgeries to decrease or prevent during surgeries; to treat severe aches resulting from Paget’s disease; to slow or prevent the development of paralysis or weakness in patients who cannot have surgery; to attempt to prevent arthritis, further deformity or loss of hearing. Alendronate and Etidronate usually is taken by mouth and Pamidronate-intravenously. Calcitonin is performed by an injection in the muscle or skin, or as a nasal spray.

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