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Paget’S Disease Of Bone

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Paget’S Disease Of Bone

  1. 1. Paget’s Disease of Bone (Osteitis Deformans) Hosain Bouallouch Shen Zhou University 10 maart 2006
  2. 2. What is Paget’s disease? <ul><li>It’s a chronic disease of the skeleton </li></ul><ul><li>Normal growth of bone is changed </li></ul><ul><li>*Bone breaks down more quickly </li></ul><ul><li>*Bone can grow larger than before </li></ul>
  3. 3. Bone consists of: Osteoblasts: bone forming cells Osteoclasts: Bone breaking cells Osteocytes: present in the matrix Matrix: collagen, calcium, osteocalcin
  4. 4. Bone remodeling
  5. 5. 2 forms of Paget’s disease <ul><li>Too much bone is formed, so gets larger and breaks easier </li></ul><ul><li>Bone that’s replaced is soft and porous </li></ul>
  6. 6. Bones commonly affected by Paget’s disease
  7. 7. Symptoms <ul><li>Pain in or over a bone </li></ul><ul><li>The affected area may feel extra warm </li></ul><ul><li>The shape of the bone may change </li></ul><ul><li>-the bone in the legs may bend or bow out </li></ul><ul><li>-the bone in the skull may get bigger </li></ul>
  8. 9. Skull of patient with paget’s disease normal skull
  9. 10. <ul><li>Bone breaks more easily </li></ul><ul><li>In late stages hipjoint may damage </li></ul><ul><li>Hearing problems may occur because the bone expands and heart problems may also occur </li></ul>Symptoms
  10. 11. What causes Paget’s disease <ul><li>Unknown; evidence favors an infection of genetically predisposed individuals with a measles virus of the paramyxovirus family </li></ul><ul><li>Studies have demonstrated that abnormal virus-infected osteoclasts generate IL-6, a resorptive cytokine from the bone marrow of patients with Paget’s disease </li></ul>
  11. 12. How common is Paget’s disease <ul><li>The exact number of Paget’s disease is not known </li></ul><ul><li>Men are more likely to be affected than woman </li></ul><ul><li>It usually affects people over the age of 40 years </li></ul><ul><li>It’s estimated to affect 3% of people over the age of 40 </li></ul>
  12. 13. Epidemiology <ul><li>Prevalence </li></ul><ul><li>High: United Kingdom, United States, Australia, New Zealand, Western Europe </li></ul><ul><li>Low: Scandinavia, China, Japan, India </li></ul><ul><li>Family History: positive in as many as 40% of patients </li></ul>
  13. 14. Treatment <ul><li>At this time there is no cure for Paget’s disease. Therefore treatment is designed to control the symptoms and change the rate of bone growth </li></ul>
  14. 15. Treatment <ul><li>Biphosphonates </li></ul><ul><li>heplfull in rebuilding bone </li></ul><ul><li>Inhibits bone resorption and mineralisation by promoting apoptosis of osteoclasts </li></ul><ul><li>for example Didronel, Fosamex and Actonel </li></ul>
  15. 16. Treatment <ul><li>Calcitonin </li></ul><ul><li>Slows bone loss and bone growth </li></ul><ul><li>Gives relieve of bone pain </li></ul><ul><li>Reduces skin temperature over affected bone sites </li></ul><ul><li>For example acetaminophen (Tylenol, Panadol) </li></ul>
  16. 17. Treatment <ul><li>Surgery </li></ul><ul><li>1. fractures: to allow fractures to heal in better position </li></ul><ul><li>2. bone deformity: cutting and realigning of the affected bones </li></ul><ul><li>3. severe degenerative arthritis: joint replacement of the hips, knees </li></ul>
  17. 18. <ul><li>Shall I tell you what true knowledge is? </li></ul><ul><li>If you know </li></ul><ul><li>Knowing that you know </li></ul><ul><li>And if you don’t know </li></ul><ul><li>Knowing that you don’t know </li></ul><ul><li>That is true knowledge </li></ul><ul><li>Confucius Analecten </li></ul>

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