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Nishant prestation 1

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  • 1. Paget's disease of bone
    Known as osteitisdeformans
    A chronic disorder that typically results in enlarged and deformed bones
    Paget's disease can cause bone to weaken,
    Bone pain
    The excessive breakdown and formation of bone tissue
    arthrites
    deformities,
  • 2. cause
    Virus infections
    Canine distemper virus
    Respiratory syncytial virus
    Paramyxovirus
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Symptoms
    Bone pain is the most common symptom
    Headaches and hearing loss may occur when Paget's disease affects the skull
    Pressure on nerves may occur when Paget's
    disease affects the skull or spine.
    Drowsiness
  • 8. Symptoms
    Increased head size
    Curvature of spine may occur in advanced cases
    Hip pain may occur when Paget's disease affects the pelvic or thigh bone
    Damage to joint cartilage may lead to arthrities
    Teeth may spread intraorally
    Chalkstik #: Chalkstick fractures are fractures, typically of long bones, in which the fracture is transverse to the long axis of the bone, like a broken stick of chalk.
  • 9. Diagnosis
  • 10. Diagnosis
  • 11. Skull radiograph
    cotton wool" appearance of the cranial vault
  • 12. Radiograph of left femur
    Bone with cortical thickening
  • 13. Treatment
  • Drug Therapy
    Bisphosphonates
    Five bisphosphonates are currently available.
    Didronel (etidronate disodium) -- Tablet; approved regimen is 200–400 mg once daily for 6 months;
    Aredia (pamidronate disodium) -- Intravenous; approved regimen 30 mg infusion over 4 hours on 3 consecutive days;
    Fosamax (alendronate sodium) -- Tablet; 40 mg once daily for 6 month
  • 16. Bisphosphonates
    Skelid (tiludronate disodium) -- Tablet; 400 mg (two 200 mg tablets) once daily for 3;
    Actonel (risedronate sodium) -- Tablet; 30 mg once daily for 2 months;
  • 17. Calcitonin
    Miacalcin is administered by injection; 50 to 100 units daily or 3 times per week for 6-18 months
  • 18. Surgery
    • There are generally two major complications of Paget's disease for which surgery may be recommended.
  • Surgery
    Severe degenerative arthritis -- If disability is severe and medication and physical therapy are no longer helpful, joint replacement of the hips and knees may be consider
    Bone deformity -- Cutting and realignment of Pagetic bone (osteotomy) may help painful weight bearing joints, especially the knees.
  • 19. Diet and Exercise
    Patients with Paget's disease should receive 1000-1500 mg of calcium
    Adequate sunshine
    At least 400 units of vitamin D daily
    This is especially important in patients being treated with bisphosphonates.
  • 20. Exercise
    Avoiding weight gain
    Maintaining joint mobility
    Flexibility exercises, such as stretching, improve the range of motion of muscles and joints
    Undue stress on affected bones should be avoided
    Relieve of pain
  • 21. SHOULDER EXERCISE
    The shoulder shrug is another technique that may improve posture and reduce back pain
    Begin by standing erect with dumbbells or water bottles held at the sides of the body
    Lift the shoulders toward the head by elevating the shoulder girdle, and slightly retract the scapulae to rotate the shoulders back
  • 22. SHOULDER EXERCISE
    Pause, and then return to the starting position.
    Avoid rocking or using the legs to initiate the exercise by slightly bending your knee
    Repeat the exercise three to five times
  • 23. KNEE EXCERCISE
    A good starting point is the squat which targets the gluteals, hamstrings, and quadriceps
    Start by standing erect with a neutral spine and feet shoulder-width apart
    Slowly lower the body, with the hips moving back as if sitting in a chair.
  • 24. KNEE EXCERCISE
    • Maintain the weight directly over the heels or mid-foot
    • 25. Lower to approximately 90 degrees of knee flexion.
    • 26. Pause, and then slowly return to the starting position
    • 27. Remember to keep the weight over the back portion of the foot rather than the toes; raise the arms to shoulder height to counterbalance.
  • KNEE EXCERCISE
    Repeat the exercise three to five times
    If you have trouble lowering your body until 90 degrees of knee flexion consider placing a chair behind you with some pillows in the chair.
     
    This way, you can lower your body until about 70 degrees of knee flexion (or until you feel the pillows on the chair), pause at that amount of knee flexion, and then return to starting position
  • 28. KNEE EXCERCISE
    The heel raise is another good exercise that targets the gastrocnemius and soleus
    Plantarflex up (stand on the toes) pause, then slowly lower to the starting position.
    Lastly the knee to chest technique is a great maneuver to help stretch the lower extremity and prevent cramping
  • 29. KNEE EXCERCISE
    Lie on your back and pull one knee to your chest.
    Perform 1-2 sets of 3-5 repetitions per side
    Each repetition should last 15-30 seconds