Journal of Bone Research
Open Access

Paget's Disease of Bone: Symptoms, Diagnosis, and Treatment

Jacob Rowe^{* *}Correspondence: Jacob Rowe, Department of Medicine, Northwestern University, Illinois, USA, Email:

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Description

In general, people's bones rebuild at a slower rate as they get older. However, this process of replacing the affected bones occurs more quickly in those with Paget's disease. As a result, the bone is growing abnormally. Only 1% of Americans in the United States suffer from Paget's disease of the bones, a rare chronic bone disorder that affects males much more frequently than women (three to two). Rapid isolated bone healing is a sign of Paget's disease, which affects one or more bones in the pelvis, low back (spine), hips, thighs, head (skull), and arms. Symptoms range from softer bones to larger bone development. As a result, patients may experience issues like bending, breaking, pinched nerves, arthritis, and poor hearing. The frequency of pain, fractures, and arthritis that may be caused by this condition has been demonstrated to be reduced by medical therapy to be effective.

The cause of Paget's disease is unknown. It does seem to be caused, at least in part, by inherited factors, possibly brought on by virus exposure. Before the age of 40, it is rarely identified in people, and as people aged, increasing number of people are being diagnosed with it. Paget's disease affects European populations and their descendants more commonly, which is indicative of the hereditary factor. Incidence frequently affects more than one family member in 30% of cases.

Usually, the bones' appearance on an X-ray is what prompts the physician to establish the diagnosis. The most frequent blood tests will detect an increase in Serum Alkaline Phosphatase (SAP), which is indicative of the quick turnover of new bone. The results of urine tests will also show how quickly this rebuilding is proceeding. To assess the degree of bone involvement, doctors typically do a non-invasive bone scan. It won't be necessary to biopsy the bone in order to inspect it under a microscope unless cancer is suspected. Physical assistance, such as the use of canes as walking aids, wedges in the shoe, and physical therapy, can be the main focus of treatment for Paget's disease.

For example, Acetaminophen (found in Tylenol) and antiinflammatory meds like ibuprofen and naproxen are some of the medications that can aid with Paget's disease pain management. In addition, a group of medications called bisphosphonates reduces the pain and helps in the body regulate the bonebuilding process to stimulate more normal bone growth. Physicians commonly prescribed oral medications are; Alendronate (Fosamax) or etidronate (Didronel) every day for six months, Tiludronate (Skelid) every day for three months and Risedronate (Actonel) every day for two months. For a short period of time, heartburn and sometimes increasing bone pain may be side effects of these medicines.

Similarly, injectable medications are available. Pamidronate (Aredia), an injectable treatment for Paget's disease, is administered intravenously once a month or every few months. It takes a few hours for the injection. Unusual symptoms include eye irritation and bone loss around the teeth (osteonecrosis). Zoledronate (Reclast) is injected into a vein once a year. The injection takes less than 30 minutes. A hormone called calcitonin is injected under the skin several times every week.

Surgery can be beneficial in lowering pain and enhancing function when arthritis brought on by the bone alterations of Paget's disease is present. Medical assistance is not anticipated to cure some of the already existing effects of Paget's disease, such as hearing loss, deformity, or osteoarthritis. Quality of life is not significantly affected by Paget's disease, and most people have a positive prognosis. In actuality, few individuals with Paget's disease of the bone have no complaints. Instead, the rapid bone regeneration causes consequences like bone pain, an enlarged head, bowed arms or legs, osteoarthritis, back discomfort, hearing loss, fractures, heart failure, and, very infrequently, a type of bone cancer.