Paget's Disease of Bone

Bone normally goes through a recycling process where old bone tissue is gradually replaced by new bone. Paget's disease of bone is a condition characterized by rapid loss of bone and abnormal formation of new bone. In Paget's disease, bone resorbing cells called osteoclasts are highly active, and in an effort to make up for the bone loss, bone forming cells called osteoblasts start producing abnormal bone. It affects one or more bones, which may become enlarged, deformed, weak and easily prone to fracture. Paget's disease is a rare condition that usually occurs after the age of 50.

Paget's disease of bone usually affects the spine, long bones of the limbs, pelvis and skull. Symptoms may be absent, or involve bone pain and noticeable bone deformity. Other symptoms may occur due to complications such as fractures, arthritis of the nearby joints, and nerve compression. Paget's disease of bone may rarely lead to cancer, which can cause severe pain.

To diagnose Paget's disease of bone, your doctor will perform an X-ray to identify bone abnormality. A blood test will show high levels of phosphatase. Your doctor may order a bone scan which uses radioactive material to identify bones affected by Paget's disease. Under anesthesia, a sample of bone tissue (biopsy) may be obtained through a needle or a small incision for examination in the laboratory.

If you have no symptoms, your doctor may simply monitor your condition periodically with X-rays. Medication may be prescribed to reduce pain and inflammation as well as osteoclast activity. A cane or walking aid may be recommended to take stress off the affected bones of the pelvis or legs, and reduce the risk of falls. Braces may help keep bones in alignment. In case of complications such as fractures, severe arthritis, nerve compression and cancer, surgery is recommended. Paget's disease-affected bones take longer to heal than normal bones, and require prolonged rehabilitation.