Paget’s disease is a chronic condition which interferes with your body’s normal bone remodeling process.

Bone remodeling is a process in which new bone tissue gradually replaces old bone tissue. This relationship is vital to maintain normal calcium levels in our blood.  Over time, the disease can cause affected bones to become fragile and misshapen. Paget’s disease of bone most commonly occurs in the pelvis, skull, spine and legs.

The risk of Paget’s disease of bone increases with age. Your risk also increases if any family members have the disorder. Complications of Paget’s disease of bone can include broken bones, hearing loss and pinched nerves in your spine.

Bisphosphonates — the medications also used to strengthen bones weakened by osteoporosis — are the mainstay of treatment. In severe cases, surgery may be necessary.

What are the types of Paget’s disease?

There are two types of Paget’s disease of bone:

  • When a single site of bone is affected by Paget’s disease, it is referred to as the monostotic type.
  • When multiple sites of bone are affected by Paget’s disease, it is referred to as the polyostotic type.

What causes Paget’s?

The cause of Paget’s disease of bone is controversial. Scientists suspect a combination of environmental and genetic factors contribute to the disease. Several genes appear to be linked to getting the disease.

Some scientists believe Paget’s disease of bone is related to a measles virus infection in your bone cells, but this theory is controversial.

 

Total body bone scan of a 57 year old man who had an elevated alkaline phosphatase level on a routine physical exam. He had not symptoms from his Paget's Disease. The abnormal tracer accumulation is in the left pelvis.
Pelvis radiograph on the man described above. Notice the increased sclerosis on the left side of the pelvis.

Normal tibia and fibula, left panel. Left tibia and fibula from a 72 year old lady who never received treatment for her Paget's Disease of bone. The bones are bowed laterally. There is marked cortical thickening, right panel.
Total body bone scan of a 72 year old man with long standing Paget's Disease of bone. The skull and right pelvis are involved.

Skull radiograph of the man described above. His skull is enlarged with cortical thickening and areas of increased resorption. He also has hearing loss.
Lumbar spine x-ray from a 47 year old man who had low back pain. The pain was caused by the Paget's Disease in the lumbar vertebra.

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