Overview
Paget's disease of bone is a disorder that interferes with the normal recycling process of bone tissue. It causes new bone tissue to be generated faster than usual, leading to bones that are weak, misshapen, and prone to fractures. The pelvis, skull, spine, and legs are typically affected. This condition is more common in people of European descent and those with a family history of the disease. While many cases are asymptomatic, bone pain can occur, and complications may include fractures, deformities, osteoarthritis, neurological problems, heart failure, and bone cancer. Treatment usually involves bisphosphonates, and surgery may be necessary in cases of complications.
Understanding the disease
Symptoms
Symptoms of Paget's disease of bone can include bone pain, deformities, and fractures. The rapid remodeling of bone caused by the disease produces less organized and weaker bone tissue. The disease may affect one or multiple areas of the body, and symptoms will depend on the affected location. Other potential complications include osteoarthritis, neurological problems, heart failure, and bone cancer. However, most people with Paget's disease have no symptoms.
Risk Factors
Risk factors for developing Paget's disease of bone include:
- Age: People older than 50 are more likely to develop the disease.
- Sex: Men are more commonly affected than women.
- National origin: Paget's disease of bone is more common in England, Scotland, central Europe, and Greece, as well as countries settled by European immigrants. It is uncommon in Scandinavia and Asia.
- Family history: Having a relative with Paget's disease of bone increases your risk of developing the condition.
Development
Paget's disease of bone develops when the normal recycling process of bone tissue is interrupted, causing new bone tissue to be produced faster than it should be. This rapid remodeling results in bone that is less organized and weaker than normal bone, leading to bone pain, deformities, and an increased risk of fractures. The disease primarily affects the pelvis, skull, spine, and legs, and can be more common in people of European descent and those with a family history of the condition. While the exact cause of Paget's disease of bone is unknown, it is believed to be related to genetic and environmental factors.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect Paget's disease of bone if you experience bone pain or have any of the following symptoms: tingling and weakness in an extremity, bone deformities, or unexplained hearing loss, especially if it's only on one side.
Diagnosis
Diagnosis of Paget's disease of bone typically involves a physical examination by a doctor, along with X-rays and blood tests. During the physical exam, the doctor will examine areas of the body experiencing pain. X-rays may reveal abnormalities in the bone structure, such as bone breakdown, enlargement, or deformities. Blood tests may indicate elevated levels of alkaline phosphatase, which can be a sign of Paget's disease of bone. In some cases, additional imaging tests like bone scans may also be ordered to confirm the diagnosis.
Management and Treatment
Complications
Potential complications of Paget's disease of bone include:
- Fractures and deformities: Affected bones break more easily, and extra blood vessels in these deformed bones can cause them to bleed more during repair surgeries. Leg bones can bow, affecting your ability to walk.
- Osteoarthritis: Misshapen bones can increase the amount of stress on nearby joints, causing osteoarthritis.
- Neurological problems: Overgrowth of bone can compress and damage nerves, causing pain, weakness, tingling in an arm or leg, or hearing loss.
- Heart failure: In severe cases, the increased workload on the heart can lead to heart failure.
- Bone cancer: Bone cancer occurs in up to 1% of people with Paget's disease of bone. It is important to manage the disease effectively to minimize these complications.
Home Remedies
While there are medications and treatments for managing Paget's disease of bone, there are no specific home remedies suggested. It's essential to consult a healthcare professional for proper diagnosis and treatment recommendations.
Treatment
The mainstay of treatment for Paget's disease of bone is bisphosphonates, which are medications used to strengthen bones weakened by the condition. They help reduce bone pain and prevent complications such as fractures. Surgery may be necessary if complications occur, including fractures, deformities, or neurological problems.
Preparing for medical consultation
To prepare for an appointment for Paget's disease of bone, you should make a list of your symptoms, key personal information, all medications and supplements you take, and questions to ask your doctor. It's also helpful to bring a family member or friend along for support. Additionally, your doctor may order X-rays and blood tests to confirm the diagnosis, and they may prescribe medications to reduce the activity of the disease to help manage complications.