Summary about Disease
Paget's disease of bone is a chronic disorder that can cause enlarged and misshapen bones. It is caused by the excessive breakdown and formation of bone tissue. This process can affect any bone in the body, but it most commonly occurs in the pelvis, skull, spine, and legs. While it's often asymptomatic, when symptoms occur, they can include bone pain, deformities, fractures, and arthritis in nearby joints.
Symptoms
Many people with Paget's disease don't know they have it because they have no symptoms. When symptoms do occur, they may include:
Bone pain: The most common symptom.
Bone deformities: Bones may become bowed or enlarged.
Fractures: Affected bones are more prone to fracture.
Arthritis: Paget's disease can cause arthritis in joints near affected bones.
Hearing loss: If the skull is affected, it can lead to hearing loss.
Headaches: Due to skull involvement.
Enlarged head circumference: Also due to skull involvement.
Nerve compression: Can cause pain, numbness, or tingling.
Warm skin over affected bone: Due to increased blood flow.
Causes
The exact cause of Paget's disease is unknown, but it is believed to be a combination of genetic and environmental factors. Some research suggests that a slow-acting viral infection early in life may play a role. Several genes have been linked to the disease.
Medicine Used
The main types of medications used to treat Paget's disease are:
Bisphosphonates: These are the most commonly used medications. They help to slow down the breakdown of bone. Examples include alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast).
Calcitonin: This is a hormone that can also slow down bone breakdown. It is less commonly used than bisphosphonates and is administered by injection or nasal spray.
Is Communicable
No, Paget's disease is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
Precautions for individuals with Paget's disease can include:
Regular exercise: Weight-bearing exercises can help to strengthen bones and improve balance, reducing the risk of falls.
Calcium and Vitamin D supplementation: To support bone health.
Fall prevention: Measures to prevent falls, such as removing tripping hazards and using assistive devices.
Pain management: Working with a healthcare provider to manage pain effectively.
Monitoring: Regular follow-up with a doctor to monitor the disease and adjust treatment as needed.
How long does an outbreak last?
Paget's disease is not characterized by outbreaks. It's a chronic condition. Treatment can help to manage symptoms and slow the progression of the disease, potentially leading to long periods of remission where symptoms are minimal. Without treatment, the disease progresses gradually, leading to chronic symptoms.
How is it diagnosed?
Paget's disease is typically diagnosed through:
X-rays: To identify bone changes characteristic of the disease.
Bone scan: A nuclear medicine test that can show which bones are affected.
Blood tests: Specifically, a blood test to measure levels of alkaline phosphatase, which is often elevated in people with Paget's disease.
Timeline of Symptoms
The timeline of symptoms can vary widely. Some people may remain asymptomatic for years, while others develop symptoms gradually over time. The following represents a general progression:
Early Stages: Often asymptomatic. The disease may be discovered incidentally during X-rays for other conditions.
Gradual Onset: Bone pain, stiffness, or fatigue may develop.
Progressive Symptoms: Over time, bone deformities, fractures, nerve compression symptoms (numbness, tingling), hearing loss (if skull is affected), and arthritis may appear.
Complications: In advanced stages, complications such as heart failure (due to increased blood flow to affected bones) may occur.
Important Considerations
Early diagnosis and treatment: Important to prevent complications.
Individualized treatment plans: Treatment should be tailored to the specific bones affected and the severity of symptoms.
Long-term monitoring: Necessary to monitor for disease progression and adjust treatment as needed.
Potential complications: Be aware of potential complications, such as fractures, arthritis, hearing loss, and heart failure.
Genetic counseling: If there is a family history of Paget's disease, genetic counseling may be considered.