Pagets disease

2.  Definition - idiopathic Skeletal bone disorder
in which there is excessive bone resorption
followed by replacement of altered bone
tissue
 The new bone is larger, disorganized and
structurally weaker
 Common sites– pelvis , long bones, spine,
ribs, sternum and cranium

3.  Exact cause is unknown
 Followed by viral infection (measles virus,
respiratory syncytial virus )
 Genetic (15%-30%)
 Men to women ratio – 2:1
 Seen in below 40 years

4.  Due to unknown causes
 Increase BONE RESORPTION
 Altered BONE TURN OVER
 As a compensatory mechanism - increase
bone formation
 Newly formed bones are large, unorganized
and weak
 Structural changes in weight bearing limbs
and other manifestation

5.  Free of symptoms in the early stages
 Bone pain – deep ache – progress to severe
pain
 Fatigue
 Progressive development of waddling gait
 Become shorter
 Barrel chest

6.  Bowing of tibia or femur
 Changes in skin temperature
 Manifestations related to
nerve compression

7.  Increase bone volume in the spine can cause
spinal cord or cranial root compression leads
to head ache, blindness, vertigo, hearing loss
with tinnitus and dementia
 Pathologic fracture , osteosarcoma,
fibrosacroma and osteoclastoma tumors are
complications
 Osteoarthritis are common associated with
pagets disease

8.  X rays – shows increased bone
expansion and density.
 Bone scan
 Serum alkaline phosphates levels
increased
 N-telopeptide and C-telopeptide
they are biomarkers used to
measure the rate of bone turnover,
can be measure from urine or
serum

9.  Limited to symptoms
 Supportive care
 Correction of secondary deformity
 Calcitonin – decrease osteoclastic activity