Information From Your Health Care Provider

PAGET'S DISEASE OF BONE

(Osteitis Deformans)

Basic information

description

Paget's disease of bone is a gradual, progressive bone disorder. It usually involves the bones of the skull, spine, legs, collar bone, and pelvis. It can affect both sexes and is most common in older adults. It is named for an English doctor who first described the disease. Paget's disease of the breast is a different disorder.

FREQUENT SIGNS & SYMPTOMS

Most often, there are no early symptoms.
Bone pain (especially at night).
Skin over the bones is warm.
Joint pain or stiffness.
Headaches.
Hearing loss and tinnitus (noises in the ear).
Fractures (may occur from minor trauma).
Bowing of long bones, such as of the legs.
Nerve problems, from pressure on the nerves.

causes

Unknown. It may involve genetics and/or a virus. The affected bone breaks down and then abnormal bone growth occurs. The new bone is weak, fragile, enlarged, and deformed.

risk increases with

Family history of Paget's disease.

PREVENTIVE MEASURES

No specific preventive measures.
Those with family history should have a blood-screening test periodically to help with early diagnosis.

expected outcomes

There is no cure, but treatment can control or reduce symptoms. With early treatment (before major bone changes occur), the outlook is generally good.
Research into causes and treatment continues, so there is hope for better treatment and, perhaps, a cure.

possible complications

Many complications can occur that affect different organs and body parts. Complications include arthritis, heart disease, hearing loss, kidney stones, bone cancer, vision changes, parathyroid disease, spinal disease, enlarged head, loose teeth, and others.

diagnosis & treatment

general measures

Your health care provider will do a physical exam. Medical tests may include blood and urine studies, x-rays of affected bones, and a bone scan. Hearing and vision testing may be done if the skull is involved.
Treatment may include physical therapy, use of assistive devices, drugs, exercise, home care, and surgery.
If there are no symptoms, treatment may not be needed. Follow-up exams will monitor the disease status.
Physical therapy helps maintain and improve muscle strength, range of motion, flexibility, and endurance.
Walkers, canes, crutches, special shoes, or shoe inserts may help if walking is a problem.
Use heat to relieve pain (warm compresses or soaks).
Transcutaneous electrical nerve stimulation (TENS) or massage may help muscle pain and tightness.
Accident-proof your home. Avoid throw rugs and slippery floors. Install hand rails next to the tub. Other changes may be needed depending on patient's needs.
Hearing aid may be useful if hearing loss occurs.
Rarely, splinting may be needed for severely affected areas to prevent fractures.
Bone surgery may be needed to treat fractures, correct deformities, or treat arthritis.
To learn more: Paget Foundation, 120 Wall St., Suite 1602, New York, NY 10005-4001; (800) 237-2438; website: www.paget.org.

medications

Drugs will usually be prescribed that help slow the rate of bone turnover. Several options are available and their risks and benefits will be discussed with you.
Nonprescription drugs for pain can be used. Stronger ones may be prescribed (if needed).
Calcium and vitamin D are often recommended.

activity

Home exercises will help maintain mobility. Avoid stress on affected bones. Follow instructions provided by your physical therapist or health care provider.

diet

Eat a healthy diet. Avoid weight gain.

notify our office if

You or family member has symptoms of Paget's disease of bone.
The following occur during treatment: fever, severe pain, or unexpected weight loss.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.