Pagets Disease - Symptoms and Treatment

Paget's disease is a disorder in which bone formation speeds up, changing the strength and shape of bones. The disease is named after a mid-19th-century English surgeon, Sir James Paget, who also identified Paget's disease of the breast. Other than sharing his name, however, the two conditions are unrelated. Even after you've reached your full height, your bones don't stop growing. Bone is living tissue engaged in a continual process of renewal. During this constant process called remodeling, old bone is removed and replaced by new bone. Paget's disease of bone disrupts this process. Early in the course of the disease, old bone starts breaking down faster than new bone can be built. Over time, your body responds by generating new bone at a faster than normal rate. This rapid remodeling produces bone that's softer and weaker than normal bone, which can lead to bone pain, deformities and fractures. Any part of the skeleton can be affected, but the most common sites include the skull, spine, pelvis, thigh bone, shin and the bone of the upper arm. Paget's disease tends to affect people over the age of 40 years, with around three percent of this age group affected. The rate increases to about 10 percent in people over 80 years of age. It affects men and women equally. The cause of Paget's disease is not yet fully understood. Some theories suggest people with a genetic predisposition to the disorder may become infected with an unidentified virus, which then triggers the bone abnormalities. Paget's name is also given to a skin disease, which is usually associated with an underlying cancer.

Paget's disease of bone is a chronic condition that affects bone growth, causing bones to expand and become deformed. The deformed bones then become weaker and are more likely to fracture (break). The other name of Paget's disease is osteitis deformans. In paget's disease, there is abnormality occurs in the bone cells. The most common symptom is pain. It is usually localized to one bone, but can involve many bones. The actual cause of Paget's disease is not known. Paget's is characterized by coarse, thickened bone tissue (as seen on x-ray), altered bone growth and destruction of the bone marrow (fibrosis). The skull, tibia, femur, pelvis, and spine are most often affected. Patients with Paget's can suffer from headaches, intermittent ringing in the ears, vertigo, and hearing loss. Bone pain in the spine, pelvis, hips, and legs is not uncommon. Secondary degenerative arthritis in the knee joints is also seen. Diagnosis is made by x-ray of the skull, spine, or extremities. Patients with Paget's will also have elevation of their alkaline phosphatase enzyme in their bloodstream. Blood calcium levels may be normal to elevated. Treatment of Paget's includes calcitonin (parathyroid hormone) therapy and mithramycin treatment.

Causes of Pagets Disease

Common Causes of Pagets Disease :

• Heredity problem may be another possible cause of paget's disease.
• Viral infection can lead to disease of bone i.e. paget's disease.
• Paget's may be caused by a 'slow virus' infection of bone cells. It is called 'slow' because the virus may settle in the bone cells early in life and only cause the disease many years later.

Symptoms of Pagets Disease

Some common Symptoms of Pagets Disease :

• Hearing loss.
• Headache.
• Joint pain or joint stiffness
• Neck pain.
• Bowing of the legs
• Fracture.
• Bone fractures.
• Constant fatigue.

Treatment of Pagets Disease

• The nonsteroidal anti-inflammatory drugs like aspirin and ibuprofen are usually effective for getting relief from pain.
• Sometimes surgery is needed if there is a significant bone deformity or if there is a break in the bone.
• Novartis - also called Aclasta is also used in the treatment of Paget's disease.
• Exercise.
• Maintaining normal weight .
• Such as bisphosphonates and calcitonin (used rarely), to slow the progression of the disorder.

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