Paget's Disease of Bone

Question 1

Definition of Paget’s Disease of Bone

Answer 1

• Excesive bone turnover (formation and reabsorption)
• Uncoordinated turnover leading to patchy areas of high density (sclerosis) and low density (lysis)

Question 2

Presentation of Paget’s disease of bone

Answer 2

• Bone pain
• Bone deformity
• Fractures
• Hearing loss
• Most commonly in spine, pelvis, long bones and limbs

Question 3

X-ray findings in Paget’s

Answer 3

• Bone enlargement and deformity
• Osteoporosis circumscripta (well defined osteolytic lesions that appear less dense compared with normal bone)
• Cotton wool appearance of the skill
• V-shaped defects in the long bones

Question 4

Investigations of Paget’s

Answer 4

• Raised ALP
• Normal calcium
• Normal phosphate

Question 5

Management of Paget’s

Answer 5

• Bisphosphonates are the main treatment
• Can also use NSAIDs, calcium, vitamin D supplementation
• Monitoring involves checking the serum ALP and reviewing symptoms

Question 6

Complications of Paget’s

Answer 6

• Osteogenic sarcoma
• Spinal stenosis