Pagets disease

23/06/2013 by admin | Rheumatology

(5% of UK):

  1. Disorder of bone remodeling with increased osteoclasts resorption, followed by increased bone formation (compensation of osteoblasts)
  2. Can lead to – abnormality in X-ray, pain, deformities and increased risk of fractures, cranial nerve entrapment
  3. Only 30% have symptoms!

 

P/c:

  1. Skull commonly effected and can lead to deafness
  2. Some cardiac failure as heart cannot keep up with the blood supply needed for such a high turn over.
  3. Malignancy possible but rare.
  4. Patient may become hypercalcaemic

 

Ix:

  1. On radiology = osteoblastic and osteolytic legions giving bone an odd appearance of mismatch Elevated alkaline phosphatase

 

Tx:

  1. May not be necessary
  2. First line = bisphosphonates.
  3. Calcitonin for the pain. 
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