PAGET’S DISEASE OF BONE

Overview and Facts

Paget’s disease of bone is a condition that messes up the bone’s tissue recycling process, wherein it disrupts the replacement of new bone tissues from the old bone tissue. In the long term, it can cause the bones to become fragile and misshapen. This disease usually occurs in the pelvis, skull, spine, and legs.

The risk of having this disease is based on the following:

Age. As one gets older, they are more susceptible to get Paget’s disease of the bone, especially those who are 40 years old and above.
Family history. It is most likely that you’ll have this disease if your family has this disease, since it could be passed from generation to generation.
Sex. Men have a higher tendency to get this disease than most women do.
National origin. Geographically speaking, Paget’s disease of bone is quite common to show up in England, Scotland, Central Europe, and Greece, as well as countries settled by European immigrants. This disease is rare in Scandinavia and Asian countries.

When having this disease, there are possibilities that complications may occur, such as broken bones, hearing loss, and pinched nerves in your spine. In worst-case scenarios, surgery may be necessary. When treating Paget’s Disease of Bone, bisphosphonates may be given, which helps strengthen the weak bones brought about by osteoporosis.

Types and Symptoms

TYPES

Paget’s Disease of the bone is made up of two types:

Monostotic Type. When a single area of the bone is affected by the disease.
Polyostotic Type. This is when there are multiple areas of the bones that are affected by the disease.

SYMPTOMS

There are still no evident symptoms for Paget’s disease of the bone. Most people who have this disease commonly complain about bone pain. This is due to the abnormal speed of the bone remodelling process that results in softer and weaker bones that we have, which leads to bone pain, deformities, and fractures.

This disease may only affect one or more areas in your body, such as:

Pelvis. When the disease affects the pelvis, it can cause hip pain.
Skull. Due to the disease affecting the skull, an overgrowth of bone may occur and cause hearing loss or headaches.
Spine. If the disease has affected your spine, it will result in your nerve roots being compressed, thus causing you pain, tingling, and numbness in an arm or leg.
Leg. As the bones weaken and easily bendable, it can cause you to become bow legged. And due to the continuous stress being received by the nearby joints, it’ll cause you to have osteoarthritis.

Diagnosis & Medications

DIAGNOSIS

During diagnosis, your doctor will get an X-ray of the areas that cause you pain, and blood tests to help confirm the diagnosis .

Imaging Tests

To verify if the disease has affected you, you’ll undergo the following tests:

X-rays. The first indication of having Paget’s disease of bone is by looking through an x-ray result. There may be areas of bone reabsorption, enlargement of the bone, and deformities that are similar to Paget’s disease of bone.
Bone scan. By injecting the patient with radioactive materials into their body, it’ll immediately go to the areas affected by Paget’s disease of bone. It will light up when seen through bone scan images.

Lab Tests

By taking some blood samples, it’ll be examined for high levels of alkaline phosphatase since it is one of the characteristics of having the disease.

TREATMENTS

Even if no symptoms are showing but the disease is active, your doctor will recommend you have it treated to prevent any complications from happening. The elevated alkaline phosphatase level indicates the active status of Paget’s disease, and it might affect high-risk areas of your body, such as your skull or spine.

Medications

The usual medication given to those who have Paget’s disease of bone are osteoporosis drugs (Bisphosphonates). It could be administered orally or injected. Oral drugs may irritate your gastrointestinal tract as a side effect. Examples of those drugs are:

Alendronate
Ibandronate
Pamidronate
Risedronate
Zoledronic Acid

In some rare cases, Bisphosphonate therapy can bring about severe muscle, joint, or bone pain, which might not resolve even when the medication is discontinued. This could also increase the risk of having dental diseases, such as having osteonecrosis of the jawbone, then associated with oral surgery.

Surgery

On special occasions, surgery is recommended. It is to:

Help heal the fractured areas
Replace joints damaged by severe arthritis
Realign deformed bones
Reduce pressure on nerves