- by Specialist Hospital
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- Feb 02 2018
Paget’s disease: Symptoms and Causes
It is a chronic condition of bone characterized by disorder of the normal bone remodelling process. It is the second most common type of disease, after osteoporosis. Normal bone has a balance of forces that act to lay down new bone and take up old one. This relationship is essential for maintaining the normal calcium levels in our blood.
It is very common in UK, Western Europe, and the United States, but it is very uncommon in Scandinavia, China, and India.
In bone affected by this disease, one or more localized areas of bone are affected by abnormal bone remodelling, which is disturbed and not synchronized. As a result, the bone that is formed is abnormal, enlarged, not as dense, brittle and prone to breakage.
The cause is entirely unknown. There are various hypothesis, such as,
- There appears to be a family connection.
- It is said that a virus particle, known as paramyxovirus nucleocapsid, has been identified inside the bone cells of some patients with Paget’s disease. Measles is a paramyxovirus. This virus particle is not found in normal bone.
- It is suspected that a combination of environmental and genetic factors contribute to the disease.
Symptoms of Paget’s disease are confused with those of arthritis or other disorders.
The most common symptoms are bone or joint pain. They may also have to swell of joints, tenderness, or redness, over the affected areas. The most common bones affected by Paget’s disease are the pelvis, spine skull, femur, or thigh bone, and tibia, or shin bone.
Other complications include arthritis and hearing problems.
It is diagnosed through physical examination, X-rays, and laboratory studies. The physical examination may show abnormalities of the skeletal shape or bone deformities. Laboratories studies show an increased level of alkaline phosphatase, a by-product of bone formation.
There is no cure for Paget's disease, but treatment can control and lessen its symptoms. All patients with Paget's disease do not need treatment, but if laboratory tests show that treatment is necessary, the first line of treatment will normally be bisphosphonates. Vitamin D and calcium are given to supplement.
Exposure to sunlight is also recommended, to enable the synthesis of vitamin D.
Surgery may be necessary if there is a significant bone deformity or a break in the bone.
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