AB0281 PAGET’S DISEASE: EPIDEMIOLOGICAL PROFILE
Authors: R. Ben Chehida, S. Ben Jemaa, Z. Gassara, A. Feki, M. Ezzeddine, R. Akrout, M. H. Kallel, H. Fourati, S. Baklouti
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Paget's disease is an osteopathy characterized by anarchic remodeling of bone tissue. It is a common condition affecting approximately 2% of individuals over 50 years old. The aim of our study is to delineate the epidemiological, clinical, radiological, and therapeutic characteristics of Paget's disease through an analysis of 81 cases. <h3>Objectives:</h3> Investigate the epidemiological, clinical, and radiological aspects of Paget's disease in a retrospective analysis of 81 cases over 33 years. Present demographic details, diverse symptoms, radiological findings, and outcomes of bisphosphate treatments. Conclude by emphasizing the effectiveness of bisphosphonates in treating Paget's disease and mention surgery as a viable option for joint involvement. <h3>Methods:</h3> This is a retrospective study of 81 cases of Paget's disease (PD) collected over a 33-year period. <h3>Results:</h3> Our series comprises 54 men and 27 women aged 30 to 84 years, with an average age at the time of disease discovery of 54.01 years. The presenting symptom was isolated pain in 83.95% of cases (n=68), headache with hypoacusis in 3.7% of cases (n=3), carpal tunnel syndrome in 1.23% of cases (n=1), meralgia in one case, bone deformity in 2.46% of cases (n=2), fracture in one case, inaugural spinal cord compression in 4.93% of cases (n=4), and cauda equina syndrome in the last case. <b>Regarding pain:</b> Pain was of a mechanical type in 54 patients, mixed in 11 patients, and inflammatory in 16 patients. Joint pain was observed in 47 patients, predominantly affecting the spine in 68.08% of cases (n=32), the hip joint in 21.27% of cases (n=10), the knee in 8.51% of cases (n=4), and the wrist in one patient (2.12%). In the 71 cases with radiological exploration, standard X-rays revealed an ivory vertebra in 35 cases, cranial vault condensation in 5 cases, 10 cases of hemi-pelvis or ischiopubic branch condensation, 13 cases of femur osteocondensation, and 6 cases of focal tibia condensation. Two cases of Pagetic coxopathy were observed. Bone scintigraphy in 58 cases showed increased uptake in the following locations: lumbar spine (n=24 cases), skull (n=8 cases), bones (n=18 cases), and pelvis (n=20 cases). Multiple locations could be detected in a single patient. Sixty-nine patients were treated with bisphosphonates: 51 received zoledronic acid, 8 received pamidronate, and 10 received onosode residronate. The remaining patients were lost to follow-up before initiating a therapeutic protocol. Clinical improvement was noted in 49 patients under bisphosphate treatment (pain regression, improvement in complications in association with specific management). The remaining patients continued to experience pain. <h3>Conclusion:</h3> Paget's disease is a benign bone condition effectively treated with bisphosphonates. Treatment efficacy is assessed through the evolution of bone remodeling markers, particularly alkaline phosphatases. Surgical intervention remains a viable option, especially in cases of joint involvement, such as the hip joint. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>