paget's disease of the bone

Question 1

what is paget’s disease

Answer 1

increased but uncontrolled bone turnover
excessive osteoclastic resorption, increased osteoblastic activity

Question 2

predisposing factors of paget’s disease

Answer 2

increasing age
male sex
northern latitude
family history

Question 3

clinical features of paget’s disease of the bone

Answer 3

older male with bone pain and isolated ALP
pelvis, lumbar spine, femur
bowing of tibia, bossing of skull

Question 4

investigations in paget’s disease

Answer 4

bloods: raised ALP, calcium and phosphate normal
markers of bone turnover
x-rays- first line
- osteolysis, skull x-ray: thickened vault, osteoporosis circumscripta
bone scintigraphy

Question 5

management of paget’s disease of the bone

Answer 5

indications for treatment: bone pain, skull of long bone deformity, fracture, pariarticular

bisphosphonates (oral risedronate or IV zoledronate)
calcitonin

Question 6

complications of paget’s disease of the bone

Answer 6

deafness
bone sarcoma
fractures
skull thickening
high output cardiac failure