Question: What is (are) Paget's Disease of Bone ?
Answer: Enlarged and Misshapen Bones Paget's disease of bone causes affected bones to become enlarged and misshapen. Our bones are living tissue, and our bodies are constantly breaking down old bone and replacing it with new bone. In Paget's disease, however, old bone is broken down and replaced at a faster rate than normal. The new bone is larger and weaker than normal bone. Paget's disease can occur in any bone in the body, but it is most common in the pelvis, spine, skull, and leg bones. It may occur in just one bone or in several bones, but it does not affect the entire skeleton or spread from affected bones to normal bones. Common symptoms include pain, misshapen bones, and a greater chance of broken bones. Complications Paget's disease can also lead to complications, such as arthritis, headaches, hearing loss, or nervous system problems, depending on which bones are affected. If not treated, Paget's disease can reduce a person's ability to perform activities of daily living, thereby reducing quality of life. Although it is the second most common bone disease after osteoporosis, Paget's disease is still uncommon. According to Bone Health and Osteoporosis: A Report of the Surgeon General, an estimated 1 million people in the U.S. have Paget's disease, or about 1.3 people per 100 men and women age 45-74. The disease is more common in older people and those of Northern European heritage. Men are more likely than women to have the disease. Cause is Unknown Paget's disease is named after the British surgeon, Sir James Paget, who first identified the disease in 1877. Researchers are not sure what causes it. Heredity may be a factor in some cases. Research suggests that a close relative of someone with Paget's disease is seven times more likely to develop the disease than someone without an affected relative. However, most people with Paget's disease do not have any relatives with the disease. Researchers think the disease also may be caused by other factors, such as a slow-acting virus. A Treatable Disease The good news is that Paget's disease of bone is treatable, especially if it is diagnosed early. In recent years, the Food and Drug Administration has approved several medications that can stop or slow the disease's progression. In some cases, surgery can help patients manage the symptoms and complications of the disease.
Source: NIHSeniorHealth

Question: How to diagnose Paget's Disease of Bone ?
Answer: An Underdiagnosed Disease Experts believe that Paget's disease is underdiagnosed; people with a mild case and no symptoms may never know they have the disease. Or, they may receive a diagnosis by accident when x-rays or other laboratory tests done for another reason reveal Paget's disease. When symptoms do occur, they usually appear gradually and, in the early stages, may be confused with those of arthritis or other medical problems. Sometimes a person may not receive a clear diagnosis until the disease progresses and complications develop. Diagnostic Tests X-rays are almost always used to diagnose Paget's disease, but the disease may be discovered using one of three tests: - x-rays - an alkaline phosphatase blood test - or a bone scan. x-rays an alkaline phosphatase blood test or a bone scan. Bones affected by Paget's disease have a distinctive appearance on x-rays, which may show increased bone density, an abnormal bone structure, bowing, and enlargement. X-rays of leg bones may show very tiny fractures called microfractures. The enzyme alkaline phosphatase is involved in the normal growth of new bone. Having higher-than-normal levels of this chemical in the blood, however, may be a sign of Paget's disease. The alkaline phosphatase blood test measures the level of this substance. A bone scan provides a picture of the affected bones that doctors can use to see how far the disease has progressed. If a bone scan done for another reason suggests Paget's disease, the doctor can order x-rays to confirm the diagnosis. If the Disease Runs in the Family Early diagnosis and treatment of Paget's disease is important. Because Paget's disease can be hereditary, some experts recommend that the brothers, sisters, and children of anyone with the disease talk to their doctor about having an alkaline phosphatase blood test every 2 to 3 years after about age 40.
Source: NIHSeniorHealth

Question: What are the treatments for Paget's Disease of Bone ?
Answer: Early Diagnosis is Important Although there is no cure for Paget's disease of bone, it is treatable. Treatment is most effective when the disease is diagnosed early, before it causes major changes in the affected bones. The goal of treatment is to relieve bone pain and prevent the disease from progressing. Medications Are Available The Food and Drug Administration has approved several medications that can stop or slow down the progression of the disease and reduce pain and other symptoms. These medications fall into two categories: bisphosphonates and calcitonin. Both medications work by stopping or reducing the excessive breakdown of old bone that leads to excessive formation of new, but weaker, bone. People with Paget's disease should talk to their doctors about which medication is right for them. Bisphosphonates Six bisphosphonates are currently available for patients with Paget's disease. Doctors most commonly recommend the strongest ones, which include - risedronate - alendronate - pamidronate - zoledronic acid - tiludronate and etidronate are not as strong but may be appropriate for some patients. risedronate alendronate pamidronate zoledronic acid tiludronate and etidronate are not as strong but may be appropriate for some patients. Some of the bisphosphonates approved for the treatment of Paget's disease, including risedronate and alendronate, are also approved for the treatment of osteoporosis. However, people with Paget's disease must take higher dosages of these medicines for shorter periods of time than people with osteoporosis. Calcitonin Doctors also may prescribe calcitonin to treat Paget's disease in some people, although it has been found to be less effective than bisphosphonates. Calcitonin is a naturally occurring hormone made by the thyroid gland. Your doctor may recommend that you repeat calcitonin treatments with brief rest periods in between treatments. The nasal spray form of calcitonin is not recommended or approved to treat Paget's disease. Surgery Surgery may be a treatment option for some people. Hip or knee replacement surgery may help people with severe arthritis. Surgery can also realign affected leg bones to reduce pain or help broken bones heal in a better position. Nutrition and Exercise Good nutrition and exercise are important for bone health, and that is true for people with Paget's disease as well. Women over age 50 should consume 1,200 milligrams (mg) of calcium daily. Men between the ages of 51 and 70 should consume 1,000 mg of calcium a day, and men over 70 should consume 1,200 mg per day. People ages 51 to 70 should consume at least 600 international units (IU) of vitamin D daily. People over age 70 should consume at least 800 IUs daily. Calcium keeps bones strong, and vitamin D helps the body absorb calcium. Exercise is very important in maintaining bone health, avoiding weight gain, and keeping joints mobile. However, people with Paget's disease need to avoid putting too much stress on affected bones. They should discuss their exercise program with their doctor to make sure it is a good one for them. Finding New Treatments Recently, there have been major advances in the treatment of Paget's disease of bone. Research into new treatments continues. Some researchers are trying to identify the genetic and viral causes of the disease. Other researchers are learning more about bone biology to better understand how the body breaks down old bone and replaces it with new bone.
Source: NIHSeniorHealth

Question: What is (are) Paget's Disease of Bone ?
Answer: Paget's disease of bone is a disease that causes affected bones to become enlarged and misshapen. Our bones are living tissue, and our bodies are constantly breaking down old bone and replacing it with new bone. In Paget's disease, however, old bone is broken down and replaced at a faster rate than normal. The new bone is larger and weaker than normal bone.
Source: NIHSeniorHealth

Question: What are the symptoms of Paget's Disease of Bone ?
Answer: Pain may be a symptom, especially among people with more advanced Paget's disease. Affected bones also can become enlarged, misshapen, and more fragile and likely to break. Misshapen bones tend to be most noticeable in the legs, skull, and spine.
Source: NIHSeniorHealth

Question: What are the complications of Paget's Disease of Bone ?
Answer: Over time, Paget's disease may lead to other medical conditions, including arthritis, headaches, hearing loss, and nervous system problems, depending on which bones are affected. On very rare occasions, Paget's disease is associated with the development of osteosarcoma, a type of bone cancer. Less than one percent of patients have this complication.
Source: NIHSeniorHealth

Question: What are the treatments for Paget's Disease of Bone ?
Answer: The Food and Drug Administration has approved several medications that can stop or slow down the progression of the disease and reduce pain and other symptoms. These medications fall into two categories: bisphosphonates and calcitonin. Doctors most often prescribe one of the four strongest bisphosphonates, which are risedronate, alendronate, pamidronate, and zoledronic acid.
Source: NIHSeniorHealth