Paget's disease is a chronic bone disorder caused by excessive breakdown and abnormal regrowth of bone tissue. It most commonly affects the pelvis, femur, tibia, and skull. While the exact cause is unknown, it often runs in families and has been linked to viral infections. Patients may experience pain, bone deformities, arthritis, and hearing loss. Diagnosis involves blood tests and imaging studies, while treatment focuses on managing pain and slowing bone turnover through medications like bisphosphonates. Nursing care centers on fall prevention, monitoring for complications, and providing education about the condition.

1. PAGET’S DISEASE
Submitted by :
Mukta kanbur
21NUG088
Submitted by
Mukta S Kanabur
21NUG088

2. Introduction
• Paget's disease is a chronic condition of bone characterized by
disorder of the normal bone remodeling process.
• Characterized by excessive breakdown of bone tissue followed by
abnormal bone formation.
• Also known as osteitis deformans is a bone disease unknown
cause.
• Affecting men twice as frequently as women.
• Named after the England surgeons Sir James Paget.

3. Definition
Paget’s disease of the bone is skeletal disorder resulting from
excessive osteoclastic activity, affecting the long bone , pelvis,
lumbar vertebrae and the skull predominantly.

4. Etiology
• Idiopathic
• Family history
• Common in men than women.
• Infection from blood borne viruses ,after acute viraemia,
osteoclasts become chronically infected, stimulating osteoclastic
proliferation.

5. Pathophysiology
Primary proliferation of osteoclasts
⬇️
Bone resorption
⬇️
Osteoblastic activity
⬇️
Mosiac of disorganised pattern of bone develops
⬇️
Increased vascularity
⬇️
Pathologic fracture
⬇️
structural bowing of the legs causes malalignment of hip ,Knee and ankle joint
. ⬇️
arthritis

6. Classification

7. Signs and symptoms

8. Clinical manifestations
• Pain and predisposition to fracture.
• Pagetic lesions can lead to OA , joint destruction and spinal
deformity
• Impaired hearing as a result of skull enlargement
• Tinnitus or vertigo
• Rarely heart failure, hypertension, atherosclerosis and aortic
valve calcification occur
• Malignant bone tumour

9. Diagnostic evaluation
• Elevated serum alkaline phosphatase
• Serum calcium, phosphorus and albumin levels usually normal
• Generally confirmed with radiologic examinations
• Bone scans can evaluate pagetic activity
• Bone biopsy

10. Management
• No treatment for asymptomatic paget disease
• Pain management; NSAIDS and aspirin
• Medications: Calcitonin is the main medication used for this
disease
• Bisphosphonates : Etidronate disodium ( Didronel),
alendronate(fosamax) pamidronate (aredia), risedronate(actonel)
and an antineoplastic agent plicamycin(mithramycin) .
• Tibial osteotomy done to realign knees and relieve pain.

11. Nursing management
• Assessing pain and functional ability
• Observing for bowing of legs or complaint that hats feel tight.
• Assessing for cardiovascular complications
• Assessing for auditory symptoms such as tinnitus,vertigo and
hearing loss
• Prevention of falls
• Assisting patient with activities as necessary
• Providing function and mobility aids such as heel lifts and walking
aids as needed.

12. Health education
• Teaching safety measures in the home, removal of loose rugs and obstacles to
prevent falls and good lighting
• Providing education about the disease process and medication treatment
• Making sure that patient knows how to use mobility aids
• Initating home care referral as indicated
• Encouraging follow-up for periodic hearing tests and blood work.