Paget Disease Glossary of Terms

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Abnormal: Not normal. Deviating from the usual structure, position, condition, or behavior. In referring to a growth, abnormal may mean that it is cancerous or premalignant (likely to become cancer).

Absorption: Uptake. In the biomedical sciences, absorption has diverse specific meanings.
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Aleve: See: Naproxen.

Alkaline phosphatase: An enzyme made in the liver, bone, and the placenta and normally present in high concentrations in growing bone and in bile. Alkaline phosphatase is released into the blood during injury and during such normal activities as bone growth and pregnancy. It is measured in a routine blood test.
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Arthritis: Inflammation of a joint. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of arthritis. (see osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, pseudogout).

Back pain: Pain felt in the low or upper back. There are many causes of back pain.
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Bisphosphonate: A class of drugs used to strengthen bone. Bone is in a constant state of remodeling, whereby new bone is laid down by cells called osteoblasts while old bone is removed by cells called osteoclasts. Bisphosphonates inhibit bone removal (resorption) by the osteoclasts. Bisphosphonates are used to treat osteoporosis and the bone pain from diseases such as metastatic breast cancer, multiple myeloma, and Paget's disease. The bisphosphonates include Fosamax (alendronate) and Aredia (pamidronate).

Bladder: Any pouch or other flexible enclosure that can hold liquids or gases but usually refers to the hollow organ in the lower abdomen that stores urine -- the urinary bladder. The kidneys filter waste from the blood and produce urine, which enters the bladder through two tubes called ureters. Urine leaves the bladder through another tube, the urethra. In women, the urethra is a short tube that opens just in front of the vagina. In men, it is longer, passing through the prostate gland and then the penis. Infection of the bladder is called cystitis.

Bowel: Another name for the intestine. The small bowel and the large bowel are the small intestine and large intestine, respectively.
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Calcitonin: A hormone produced by the thyroid gland that lowers the levels of calcium and phosphate in the blood and promotes the formation of bone.
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Calcium: A mineral found mainly in the hard part of bones, where it is stored. Calcium is added to bones by cells called osteoblasts and is removed from bones by cells called osteoclasts. Calcium is essential for healthy bones. It is also important for muscle contraction, heart action, nervous system maintenance, and normal blood clotting. Food sources of calcium include dairy foods, some leafy green vegetables such as broccoli and collards, canned salmon, clams, oysters, calcium-fortified foods, and tofu. According to the National Academy of Sciences, adequate intake of calcium is 1,200 milligrams a day (four glasses of milk) for men and women 51 and older, 1,000 milligrams a day for adults 19 through 50, and 1,300 milligrams a day for children 9 through 18. The upper limit for calcium intake is 2.5 grams daily.

Compression: 1. The act of pressing together. As in a compression fracture, nerve compression, or spinal cord compression.
2. To shorten in time. In embryology, there may be compression of development with some stages even omitted.

Congestive heart failure: Inability of the heart to keep up with the demands on it and, specifically, failure of the heart to pump blood with normal efficiency. When this occurs, the heart is unable to provide adequate blood flow to other organs such as the brain, liver and kidneys. Heart failure may be due to failure of the right or left or both ventricles. The signs and symptoms depend upon which side of the heart is failing. They can include shortness of breath (dyspnea), asthma due to the heart (cardiac asthma), pooling of blood (stasis) in the general body (systemic) circulation or in the liver's (portal) circulation, swelling (edema), blueness or duskiness (cyanosis), and enlargement (hypertrophy) of the heart.
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Deafness: Deafness is defined by partial or complete hearing loss. Levels of hearing impairment vary from a mild but important loss of sensitivity to a total loss of hearing. Older adults suffer most often from hearing loss. Age-related hearing loss affects 30 to 35 percent of the population between the ages of 65 and 75 years, and 40 percent of the population over the age of 75. The most common cause of hearing loss in children is otitis media, a disorder that affects predominantly infants and young children. A substantial number of hearing impairments are caused by environmental factors such as noise, drugs, and toxins. Many sensorineural hearing losses result from a genetic predisposition.

Decompression: 1. In general, the removal of pressure.
2. In surgery, a procedure to remove pressure on a structure, as in decompression of the spinal cord.
3. The lessening of atmospheric pressure on deep-sea divers returning to the surface, or on persons ascending to great heights.

Degenerative joint disease: Also known as osteoarthritis, this type of arthritis is caused by inflammation, breakdown and eventual loss of the cartilage of the joints. Among the over 100 different types of arthritis conditions, osteoarthritis is the most common, affecting usually the hands, feet, spine, and large weight-bearing joints, such as the hips and knees. Also called degenerative arthritis.

Diagnosis: 1 The nature of a disease; the identification of an illness. 2 A conclusion or decision reached by diagnosis. The diagnosis is rabies. 3 The identification of any problem. The diagnosis was a plugged IV.
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Dysfunction: Difficult function or abnormal function.
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Ear: The hearing organ. There are three sections of the ear, according to the anatomy textbooks. They are the outer ear (the part we see along the sides of our head behind the temples), the middle ear, and the inner ear. But in terms of function, the ear has four parts: those three and the brain. Hearing thus involves all parts of the ear as well as the auditory cortex of the brain. The external ear helps concentrate the vibrations of air on the ear drum and make it vibrate. These vibrations are transmitted by a chain of little bones in the middle ear to the inner ear. There they stimulate the fibers of the auditory nerve to transmit impulses to the brain.
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Erosion: An erosion is an eating away of a surface. ("Erodere" in Latin means to eat out.)
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Esophagus: The tube that connects the pharynx (throat) with the stomach. The esophagus lies between the trachea (windpipe) and the spine. It passes down the neck, pierces the diaphragm just to the left of the midline, and joins the cardiac (upper) end of the stomach. In an adult, the esophagus is about 25 centimeters (10 inches) long. When a person swallows, the muscular walls of the esophagus contract to push food down into the stomach. Glands in the lining of the esophagus produce mucus, which keeps the passageway moist and facilitates swallowing. Also known as the gullet or swallowing tube. From the Greek oisophagos, from oisein meaning to bear or carry + phagein, to eat.

Food and Drug Administration: The FDA, an agency within the U.S. Public Health Service, which is a part of the Department of Health and Human Services.
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Fracture: A break in bone or cartilage. Although usually the result of trauma, a fracture can be caused by an acquired disease of bone such as osteoporosis or by abnormal formation of bone in a disease such as osteogenesis imperfecta ("brittle bone disease"). Fractures are classified according to their character and location as, for example, a greenstick fracture of the radius.
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Genetic: Having to do with genes and genetic information.

Heart: The muscle that pumps blood received from veins into arteries throughout the body. It is positioned in the chest behind the sternum (breastbone; in front of the trachea, esophagus, and aorta; and above the diaphragm muscle that separates the chest and abdominal cavities. The normal heart is about the size of a closed fist, and weighs about 10.5 ounces. It is cone-shaped, with the point of the cone pointing down to the left. Two-thirds of the heart lies in the left side of the chest with the balance in the right chest.
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Heart failure: Inability of the heart to keep up with the demands on it and, specifically, failure of the heart to pump blood with normal efficiency. When this occurs, the heart is unable to provide adequate blood flow to other organs such as the brain, liver and kidneys. Heart failure may be due to failure of the right or left or both ventricles. The signs and symptoms depend upon which side of the heart is failing. They can include shortness of breath (dyspnea), asthma due to the heart (cardiac asthma), pooling of blood (stasis) in the general body (systemic) circulation or in the liver's (portal) circulation, swelling (edema), blueness or duskiness (cyanosis), and enlargement (hypertrophy) of the heart.
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Hormone: A chemical substance produced in the body that controls and regulates the activity of certain cells or organs.
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Ibuprofen: A non-steroidal anti-inflammatory drug (NSAID) commonly used to treat pain, swelling, and fever. Common brand names for Ibuprofen include Advil, Motrin, and Nuprin.

Inner ear: There are three sections of the ear. They are the external ear, the middle ear, and the inner ear. The inner ear is far and away the most highly complex. The essential component of the inner ear for hearing is the membranous labyrinth where the fibers of the auditory nerve (the nerve connecting the ear to the brain) end. The membranous labyrinth is a system of communicating sacs and ducts (tubes) filled with fluid (the endolymph). The membranous labyrinth is lodged within a cavity called the bony labyrinth. At some points the membranous labyrinth is attached to the bony labyrinth and at other points the membranous labyrinth is suspended in a fluid (the perilymph) within the bony labyrinth.
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Internal medicine: A medical specialty dedicated to the diagnosis and medical treatment of adults. A physician who specializes in internal medicine is referred to as an internist. A minimum of seven years of medical school and postgraduate training are focused on learning the prevention, diagnosis, and treatment of diseases of adults. Subspecialties of internal medicine include allergy and immunology, cardiology (heart), endocrinology (hormone disorders), hematology (blood disorders), infectious diseases, gastroenterology (diseases of the gut), nephrology (kidney diseases), oncology (cancer), pulmonology (lung disorders), and rheumatology (arthritis and musculoskeletal disorders).

Joint: A joint is the area where two bones are attached for the purpose of motion of body parts. A joint is usually formed of fibrous connective tissue and cartilage. An articulation or an arthrosis is the same as a joint.
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Knee: The knee is a joint which has three parts. The thigh bone (the femur) meets the large shin bone (the tibia) to form the main knee joint. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (the patella) joins the femur to form a third joint, called the patellofemoral joint. The patella protects the front of the knee joint.
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Laboratory: A place for doing tests and research procedures and preparing chemicals, etc. Although "laboratory" looks very like the Latin "laboratorium" (a place to labor, a work place), the word "laboratory" came from the Latin "elaborare" (to work out, as a problem, and with great pains), as evidenced by the Old English spelling "elaboratory" designating "a place where learned effort was applied to the solution of scientific problems."

Magnetic resonance imaging: A special radiology technique designed to image internal structures of the body using magnetism, radio waves, and a computer to produce the images of body structures. In magnetic resonance imaging (MRI), the scanner is a tube surrounded by a giant circular magnet. The patient is placed on a moveable bed that is inserted into the magnet. The magnet creates a strong magnetic field that aligns the protons of hydrogen atoms, which are then exposed to a beam of radio waves. This spins the various protons of the body, and they produce a faint signal that is detected by the receiver portion of the MRI scanner. A computer processes the receiver information, and an image is produced. The image and resolution is quite detailed and can detect tiny changes of structures within the body, particularly in the soft tissue, brain and spinal cord, abdomen and joints.
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Malignant: 1. Tending to be severe and become progressively worse, as in malignant hypertension. 2. In regard to a tumor, having the properties of a malignancy that can invade and destroy nearby tissue and that may spread (metastasize) to other parts of the body.
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Measles: An acute and highly contagious viral disease characterized by fever, runny nose, cough, red eyes, and a spreading skin rash. Measles, also known as rubeola, is a potentially disastrous disease. It can be complicated by ear infections, pneumonia, encephalitis (which can cause convulsions, mental retardation, and even death), the sudden onset of low blood platelet levels with severe bleeding (acute thrombocytopenic purpura), or a chronic brain disease that occurs months to years after an attack of measles (subacute sclerosing panencephalitis).
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MRI: Abbreviation and nickname for magnetic resonance imaging. For more information, see: Magnetic Resonance Imaging; Paul C. Lauterbur; Peter Mansfield.

Muscle: Muscle is the tissue of the body which primarily functions as a source of power. There are three types of muscle in the body. Muscle which is responsible for moving extremities and external areas of the body is called "skeletal muscle." Heart muscle is called "cardiac muscle." Muscle that is in the walls of arteries and bowel is called "smooth muscle."

Naprosyn: See: Naproxen.

Naproxen: A non-steroidal anti-inflammatory drug (NSAID) used for the management of mild to moderate pain, fever, and inflammation. Naproxen blocks the enzyme cyclooxygenase that makes prostaglandins, resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain and fever are reduced. Brand names for naproxen include Anaprox, Naprelan, Naprosyn, and Aleve.
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Nerve: A bundle of fibers that uses chemical and electrical signals to transmit sensory and motor information from one body part to another. See: Nervous system.

Osteitis: Osteitis is inflammation of the bone.
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Osteitis deformans: Better known today as Paget disease, this is a chronic bone disorder that typically results in enlarged, deformed bones due to excessive breakdown and formation of bone tissue that can cause bones to weaken and may result in bone pain, arthritis, bony deformities and fractures. The disease is named for an English surgeon, Sir James Paget (1814-1899).
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Osteoporosis: Thinning of the bones with reduction in bone mass due to depletion of calcium and bone protein. Osteoporosis predisposes a person to fractures, which are often slow to heal and heal poorly. It is more common in older adults, particularly post-menopausal women; in patients on steroids; and in those who take steroidal drugs. Unchecked osteoporosis can lead to changes in posture, physical abnormality (particularly the form of hunched back known colloquially as "dowager's hump"), and decreased mobility.
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Pagetic: Pertaining to Paget disease, a chronic disorder that typically results in enlarged, deformed bones due to excessive breakdown and formation of bone tissue that can cause bones to weaken and may result in bone pain, arthritis, bony deformities and fractures.
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Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia. Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors.
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Paramyxovirus: One of a group of RNA viruses that are responsible predominantly for acute respiratory diseases and are usually transmitted in an airborne manner. The paramyxoviruses include the agents of mumps, measles (rubeola), RSV (respiratory syncytial virus, which mainly afflicts children), Newcastle disease, parainfluenza, Sendai virus and Hendra virus. Many of the paramyxoviruses cause disease in animals such as canine distemper and turkey rhinotracheitis.
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Parathyroid hormone: See Parathormone.

Pathologic: 1. Indicative of or caused by disease, as in a pathologic fracture, pathologic tissue, or pathologic process. 2. Pertaining to pathology, the branch of medicine that studies disease and especially the essential nature of disease.

Pharmacy: A location where prescription drugs are sold. A pharmacy is, by law, constantly supervised by a licensed pharmacist.

Phosphate: A form of phosphoric acid. Calcium phosphate makes bones and teeth hard.

Physical therapy: A branch of rehabilitative health that uses specially designed exercises and equipment to help patients regain or improve their physical abilities. Physical therapists work with many types of patients, from infants born with musculoskeletal birth defects, to adults suffering from sciatica or the after- effects of injury, to elderly post-stroke patients.

Resorption: The process of losing substance. Bone, when it is remodeled (reshaped), undergoes both new formation and resorption. The cell responsible for the resorption of bone is called an osteoclast.

Respiratory: Having to do with respiration, the exchange of oxygen and carbon dioxide. From the Latin re- (again) + spirare (to breathe) = to breathe again.

Rheumatology: A subspecialty of internal medicine that involves the non-surgical evaluation and treatment of the rheumatic diseases and conditions. Rheumatic diseases and conditions are characterized by symptoms involving the musculoskeletal system. Many of the rheumatic diseases and conditions feature immune system abnormalities. Therefore, rheumatology also involves the study of the immune system. Classical rheumatology training includes 4 years of medical school, 1 year of internship in internal medicine, 2 years of internal medicine residency, and 2 years of rheumatology fellowship. There is a subspecialty board for rheumatology certification. The American College of Rheumatology is the official organization acting on behalf of the field of rheumatology in the United States.

Sarcoma: One of a group of tumors usually arising from connective tissue. Most sarcomas are malignant. Many types are named after the type of cell, tissue, or structure involved, as in angiosarcoma, chondrosarcoma, fibrosarcoma, liposarcoma,and osteosarcoma.

Sclerosis: Localized hardening of skin.

Skeleton: The skeleton is composed of bones and is the framework of the body.

Skull: The skull is a collection of bones which encase the brain and give form to the head and face. The bones of the skull include the following: the frontal, parietal, occipital, temporal, sphenoid, ethmoid, zygomatic, maxilla, nasal, vomer, palatine, inferior concha, and mandible.
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Spinal cord: The major column of nerve tissue that is connected to the brain and lies within the vertebral canal and from which the spinal nerves emerge. Thirty-one pairs of spinal nerves originate in the spinal cord: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal. The spinal cord and the brain constitute the central nervous system (CNS). The spinal cord consists of nerve fibers that transmit impulses to and from the brain. Like the brain, the spinal cord is covered by three connective-tissue envelopes called the meninges. The space between the outer and middle envelopes is filled with cerebrospinal fluid (CSF), a clear colorless fluid that cushions the spinal cord against jarring shock. Also known simply as the cord.
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Spinal stenosis: Narrowing of the spaces in the spine, resulting in compression of the nerve roots or spinal cord by bony spurs or soft tissues, such as disks, in the spinal canal. This occurs most often in the lumbar spine (in the low back) but also occurs in the cervical spine (in the neck) and less often in the thoracic spine (in the upper back).
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Spine: 1) The column of bone known as the vertebral column, which surrounds and protects the spinal cord. The spine can be categorized according to level of the body: i.e., cervical spine (neck), thoracic spine (upper and middle back), and lumbar spine (lower back). See also vertebral column. 2) Any short prominence of bone. The spines of the vertebrae protrude at the base of the back of the neck and in the middle of the back. These spines protect the spinal cord from injury from behind.

Stenosis: A narrowing, as in:

• aortic stenosis (narrowing of the aortic valve of the heart),
• pulmonary stenosis (narrowing of the pulmonary valve of the heart),
• pyloric stenosis (narrowing of the outlet of the stomach), and
• spinal stenosis (narrowing of the vertebral canal).

Subcutaneous: Under the skin. "Subcutaneous" implies just under the skin.
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Surgery: The word "surgery" has multiple meanings. It is the branch of medicine concerned with diseases and conditions which require or are amenable to operative procedures. Surgery is the work done by a surgeon. By analogy, the work of an editor wielding his pen as a scalpel is s form of surgery. A surgery in England (and some other countries) is a physician's or dentist's office.
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Symptom: Any subjective evidence of disease. Anxiety, lower back pain, and fatigue are all symptoms. They are sensations only the patient can perceive. In contrast, a sign is objective evidence of disease. A bloody nose is a sign. It is evident to the patient, doctor, nurse and other observers.

Therapy: The treatment of disease.
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Throat: The throat is the anterior (front) portion of the neck beginning at the back of the mouth, consisting anatomically of the pharynx and larynx. The throat contains the trachea and a portion of the esophagus.

Tumor: An abnormal mass of tissue. Tumors are a classic sign of inflammation, and can be benign or malignant (cancerous). There are dozens of different types of tumors. Their names usually reflect the kind of tissue they arise in, and may also tell you something about their shape or how they grow. For example, a medulloblastoma is a tumor that arises from embryonic cells (a blastoma) in the inner part of the brain (the medulla). Diagnosis depends on the type and location of the tumor. Tumor marker tests and imaging may be used; some tumors can be seen (for example, tumors on the exterior of the skin) or felt (palpated with the hands).
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Urine: Liquid waste. The urine is a clear, transparent fluid. It normally has an amber color. The average amount of urine excreted in 24 hours is from 40 to 60 ounces (about 1,200 cubic centimeters). Chemically, the urine is mainly an aqueous (watery) solution of salt (sodium chloride) and substances called urea and uric acid. Normally, it contains about 960 parts of water to 40 parts of solid matter. Abnormally, it may contain sugar (in diabetes), albumen (a protein) (as in some forms of kidney disease), bile pigments (as in jaundice), or abnormal quantities of one or another of its normal components.

Viral: Of or pertaining to a virus. For example, "My daughter has a viral rash."

Virus: A microorganism smaller than a bacteria, which cannot grow or reproduce apart from a living cell. A virus invades living cells and uses their chemical machinery to keep itself alive and to replicate itself. It may reproduce with fidelity or with errors (mutations)-this ability to mutate is responsible for the ability of some viruses to change slightly in each infected person, making treatment more difficult.
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X-ray: 1. High-energy radiation with waves shorter than those of visible light. X-rays possess the properties of penetrating most substances (to varying extents), of acting on a photographic film or plate (permitting radiography), and of causing a fluorescent screen to give off light (permitting fluoroscopy). In low doses X-rays are used for making images that help to diagnose disease, and in high doses to treat cancer. Formerly called a Roentgen ray. 2. An image obtained by means of X-rays.