Paget’s Disease of Bone, named after Sir James Paget, British surgeon who had first described it in the late 19th century, is chronic bone condition. Its characteristics are enlarged and deformed bones. Cells that break down old bones and cells that form new bones participate in everyday process called remodeling. That process is vital for normal calcium level in our blood. However, remodeling of bones affected by this disease, also known as osteitis deformans, is disturbed, which results in abnormal, large bones, susceptible to fractures and deformities.
Patients with Paget’s Disease are often not aware of their illness, since there are no symptoms at all, or if they do have some symptoms, they connect them with arthritis or similar disorders. So, Paget’s Disease is often diagnosed by accident during X-rays or other tests executed for different reasons. Paget’s Disease can affect any bone in the body, but most commonly affected bones are spine, thigh bone – femur, skull, pelvis, collar bone – clavicle and upper arm bone – humerus.
When symptoms occur, the most common one is pain in affected bone, often in the areas adjacent to joints. Other symptoms depend on the bone that is affected, causing:
- headaches and hearing loss
- tingling and numbness due to pressure on nerves
- drowsiness due to vascular steal syndrome of the skull
- curvature of spine
- paralysis due to vascular steal syndrome of the vertebrae…
Although there is no final definition regarding the causes of Paget’s Disease, some scientists have come to conclusion that viral infections, present in your body, might be the cause of this disorder. But even if that’s true, there is no evidence that Paget’s Disease is contagious. Hereditary factor must also be mentioned here since some genes, namely Sequestrosome 1 gene on chromosome 5, have been linked with osteitis deformans.
When talking about treatment of Paget’s Disease, there are non-surgical and surgical methods. Non-surgical methods, especially for patients that don’t have any symptoms, consist of periodical X-ray examinations in order to see if there is any deterioration. For patients with mild symptoms, treatment is often focused on controlling of the disease by prescribing nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin. For those with more sever pains, doctors prescribe medications called bisphosphonates, either intravenous or oral, which would be decided by doctor based on pationt’s condition.
As far as surgical treatment is concerned, it is used if a bone is broken, badly aligned or if pressure on nerve exists, specially in skull or spine. Surgery is also an option in cases of Paget’s sarcoma when entire tumor has to be taken out. If a surgery is to be conducted on patient with Paget’s disease, patients might need bisphosphonates prior to surgery in order to prevent potential blood loss.
Perspective for Paget’s Disease patients is quite optimistic, especially if they have started their treatment before major changes in affected bones. Such patients should eat well and include sufficient quantities of calcium and Vitamin D in their daily diet; exercise regularly in order to maintain joint mobility and bone strength; try to prevent falls and avoid fractures. They should focus on how to make their life less stressful knowing they have such chronic disorder.
