Doctor's Notes on Paget's Disease
Paget's disease (also termed osteitis deformans) is a disorder that affects the normal bone remodeling process. Patients have accelerated bone resorption and new bone formation that results in abnormal bone that is weaker, larger, and more fragile than normal. Many people have no symptoms; the disease is found incidentally in an X-ray ordered for another reason. When signs and symptoms do occur, the most common is pain (joint, hip, neck, and low back). Less common symptoms and signs include fractures, bowing of leg bones, hearing loss, headaches, and muscle weakness.
The cause of Paget's disease is uncertain. Some researchers suggest several viral causes, but the theories are unproven; others suggest a possible genetic link.
What Is the Treatment for Paget's Disease?
Some patients do not need treatment. However, those who have symptoms and/or have sites like the brain or spinal cord involved may need bisphosphonates that strengthen bone:
- IV bisphosphonates
- Oral bisphosphonates
If the above are not tolerated, calcitonin (hormone used in calcium and bone metabolism) may be used. Rarely, surgery might be used to reduce problems related to Paget's disease:
- Reduce bone pressure on nerves
- Help fractures heal
- Bone realignment
- Joint replacement
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.