Advertisement

Paget’s Disease

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk
Reference work entry

Abstract

Paget’s disease usually occurs past middle age with increasing frequency with age. It is often detected as an incidental finding by an X-ray or an elevated alkaline phosphatase level or when being investigated for another disorder. Most patients are asymptomatic. Symptomatic patients could present with bone pain, deformities and fractures, secondary osteoarthritis and deafness. Pagetic lesions are extremely vascular with increased blood flow, increased blood volume, high cardiac output together with cardiomegaly, left ventricular hypertrophy and cardiac failure.

Keywords

Paget’s disease Bone pain Deformities and fractures Secondary osteoarthritis Deafness Urinary hydroxyproline 

References

  1. 1.
    Josse RG, Hanley DA, Kendler D, Ste Marie LG, Adachi JD, Brown J. Diagnosis and treatment of Paget’s disease of bone. Clin Invest Med. 2007;30(5):E210–23.CrossRefPubMedGoogle Scholar
  2. 2.
    Cooper C, Harvey NC, Dennison EM, van Staa TP. Update on the epidemiology of Paget’s disease of bone. J Bone Miner Res. 2006;Suppl 2:P3–8.Google Scholar
  3. 3.
    Walsh JP. Paget’s disease of bone. Med J Aust. 2004;181(5):262–265.PubMedGoogle Scholar
  4. 4.
    Takata S. Paget’s disease of bone. Nihon Rinsho. 2006;64(9):1724–30.PubMedGoogle Scholar
  5. 5.
    Ralston SH, Langston AL, Reid IR. Pathogenesis and management of Paget’s disease of bone. Lancet. 2008;372(9633):155–63.CrossRefPubMedGoogle Scholar
  6. 6.
    Abelson A. A review of Paget’s disease of bone with a focus on the efficacy and safety of zoledronic acid 5mg. Curr Med Res Opin. 2008;24(3):695–705.CrossRefPubMedGoogle Scholar
  7. 7.
    McCloskey EV, Neurological complications of Paget’s disease. Clin Rev Bone Miner Metab. 2002;1:135–4.CrossRefGoogle Scholar
  8. 8.
    Kristensen EB. Ocular manifestations in Paget’s disease (osteitis deformans). Report of a case with optic nerve involvement and ophthalmoplegia responding to adrenocorticosteroid therapy. Acta Ophthalmol (Copenh). 1091;49:741–746.Google Scholar
  9. 9.
    Poncelet A. The neurological complications of Paget’s disease. J Bone Miner Res. 1999;14 Suppl 2:88–91.CrossRefPubMedGoogle Scholar
  10. 10.
    Wootton R, Reeve J, Spellacy, Tellez-Yudilevich M. Skeletal blood flowing Paget’s disease of bone and its response to calcitonin therapy. J Bone Joint Surg Br. 1981;63B:495Google Scholar
  11. 11.
    Arnalich F, Plaza J, Sobrino JD, Oliver J, Barbado J, Pena JM, et al. Cardiac size and function in Paget’s disease of bone. Int J Cardiol. 1984;5:491.CrossRefPubMedGoogle Scholar
  12. 12.
    Bone HG. Neurological complications of Paget’s disease. J Bone Miner Res. 2006;21:Supp 2:P65–68.Google Scholar
  13. 13.
    Nellissery MJ, Padalecki SS, Brkansac Z, Singer FR, Roodman GD, Unni KK, et al. Evidence for a novel osteosarcoma tumour suppressor gene in the chromosome 18 genetically linked with Paget’s disease of bone. Am J Hum Genet. 1998;63:817–824.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Smith J, Botet JF, Yeh SD. Bone sarcomas in Paget’s disease. A study of 85 patients. Radiology. 1984;152:583.CrossRefPubMedGoogle Scholar
  15. 15.
    Alexandersen P, Peris P, Guanabens V, Byrjalsen L, Alvarez L, Solberg H, et al. Non-isomerized C-telopeptide fragments are highly sensitive markers for monitoring disease activity and treatment efficacy in Paget’s disease of bone. J Bone Miner Res. 2005;20(4):588–95.CrossRefPubMedGoogle Scholar
  16. 16.
    Selby PL, Davie MW, Ralston SH, Stone MD. Guidelines in the management of Paget’s disease of bone. Bone 2002;31:366–373.CrossRefPubMedGoogle Scholar
  17. 17.
    Scarsbrook A, Brown M, Wilson D. UK Guidelines on management of Paget’s disease of bone. Rheumatology. 2004;43(3):399–400.CrossRefPubMedGoogle Scholar
  18. 18.
    Siris ES, Lyles KW, Singer FR, Meunoier PJ. Medical management of Paget’s disease of bone: indications for treatment and review of current therapies. J Bone Miner Res. 2006;21. Suppl 2:P94–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Langston AL, Ralston SH. Management of Paget’s disease of bone. Rheumatology (Oxford). 2004;43(8): 955–9.CrossRefGoogle Scholar
  20. 20.
    Lyle KW, Siris ES, Singer FR, Meunier PJ. A clinical approach to the diagnosis and management of Paget’s disease of bone. J Bone Miner Res. 2001;16:1379–1387.CrossRefGoogle Scholar
  21. 21.
    Siris ES, Weinsteinn RS, Altman R, Conte JM, Favus M, Lombardi A, et al. Comparative study of alendronate versus etidronate for the treatment of Paget’s disease of bone. J Clin Endocrinol Metab. 1996;81:961–967.PubMedGoogle Scholar
  22. 22.
    Hosking D. Pharmacological therapy of Paget’s and other metabolic disease. Bone. 2006;38(2Suppl 2):S3–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Walsh JR, Ward LC, Stewart GO, Will RK, Cridde RA, Prince RL, et al. Randomized clinical trial compared oral alendronate and IV pamidronate for the treatment of Paget’s disease of bone. Bone. 2004;34:747–754.CrossRefPubMedGoogle Scholar
  24. 24.
    Raisz LG. Physiology and Pathophysiology of Bone Remodeling.Clin Chem 1999;45(8):1353–1358.PubMedGoogle Scholar
  25. 25.
    Singer FR. Clinical efficacy of salmon calcitonin in Paget’s disease of bone. Calcif Tissue Int. 1991;49 Suppl 2:S7–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Gagel RF, Logan C, Mallette LE. Treatment of Paget’s disease of bone with salmon calcitonin nasal spray. J Am Geriatr Soc. 1988;36(11):1010.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 1
  • Gary Cheuk
    • 2
  1. 1.The University of SydneyWestmead Clinical SchoolWestmeadAustralia
  2. 2.Rehabilitation and Aged Care ServiceBlacktown-Mt Druitt HospitalMount DruittAustralia

Personalised recommendations