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by Woods M
(Osteitis Deformans)

Definition

Paget disease (PD) is a bone disorder. Normal bone is always being broken down and built again. With PD, bones are broken down too fast. New bone is loose and bulky instead of strong and compact. This leaves bones weak. They may bend over time.

PD affects the bones of the:

  • Pelvis
  • Legs
  • Skull
  • Spine

Normal Bone Structure
Bone Matrix
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Causes

The exact cause of PD is not known. It may due to a viral infection, such as the measles.

Risk Factors

PD is more common in people who are over 55 years old. It usually occurs in people of European descent.

Your risk for PD may also be higher if you:

  • Have a gene called SQSTM1
  • Have family members with PD, such as a parent, sibling, or child
  • Use tobacco

Symptoms

Most people with PD don't have symptoms. People who do may have:

  • Bone and joint pain
  • Misshapen bones
  • Hearing loss if PD is in the skull

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done.

Your doctor will order blood tests.

Pictures will be taken of your body. This can be done with:

Treatment

It is best to start treatment as soon as you can. Talk with your doctor about the best plan for you.

Medication

These are the medicines used to treat PD:

  • Pain relievers, such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs)
  • Bisphosphonates to prevent the loss of bone and keep the disease from getting worse

Surgery

You may need surgery if you have:

  • Severe degenerative arthritis
  • Bone fracture
  • Spinal stenosis
  • Misshapen bones

Self-Care

There are things you can do to care for your PD:

  • Take calcium and vitamin D supplements.
  • Use assistive devices, such as canes and shoe lifts. They can help you if you have a limb that is too short.

Prevention

There are no methods to prevent PD.

People with close family members who have PD should screened for the SQSTM1 gene.

RESOURCES

NIH Osteoporosis and Related Bone Diseases National Resource Center  http://www.niams.nih.gov 

The Paget Foundation  http://www.paget.org 

CANADIAN RESOURCES

The Arthritis Society  http://www.arthritis.ca 

Osteoporosis Canada  http://www.osteoporosis.ca 

References

Albagha OM, Genetic Determinants of Paget's Disease (GDPD) Consortium. Genome-wide association identifies three new susceptibility loci for Paget's disease of bone. Nat Genet. 2011;43(7):685-689.

Michou L, Brown JP. Emerging strategies and therapies for treatment of Paget's disease of bone. Drug Des Devel Ther. 2011;5:225-239.

Paget disease of bone. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 10, 2015. Accessed May 11, 2016.

Schneider D, Hofmann MT, et al. Diagnosis and treatment of Paget's disease of bone. Am Fam Physician. 2002;15;65(10):2069-72.

What is Paget's disease of bone? NIH Osteoporosis and Related Bone Diseases National Resource Center website. Available at: http://www.niams.nih.gov/Health%5FInfo/Bone/Pagets/pagets%5Fdisease%5Fff.asp. Updated November 2014. Accessed May 11, 2016.

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