2024 Author: Brian Parson | [email protected]. Last modified: 2023-12-17 15:02
Paget's disease is a disease affecting the bones and the possibility of normal bone renewal. The disease was first described by physician James Paget as a bone disease that causes severe pain in the affected bones and has a varied clinical picture.
Men suffer from Paget's disease more often than women, and the age of patients in whom the disease is detected is between 40 and 50 years, juvenile forms of Paget's disease are less common. The younger the person affected by the disease, the faster and more malignant it develops.
Over time, it is possible for the disease process to become chronic and for normal bones to gradually be replaced by an atypical bone structure that deforms and thickens the bone. In normal bone modeling, there is a balance of forces that act and form new tissue.
The bones that are affected by Paget's disease have impaired modeling, there is no good synchronization between them. As a result, the deformed bone is enlarged, fragile and prone to fractures.
Causes of Paget's disease
It is not clear what the exact cause of Paget's disease. According to some scientists, the disease is caused by a viral infection that affects bone cells, while others believe that hereditary factors play an important role in the incidence of this disease.
Even after a person reaches his optimal height, his bones continue to grow, because bone is still a living tissue that does not stop being renewed.
This is a process known as remodeling, during which old bone is replaced over time by new bone tissue. In a person with Paget's disease the process is disrupted.
At the very beginning of the development of the disease, the old bone tissue begins to break down faster, and the new one fails to form fast enough to compensate for the destruction.
Over time, the body still manages to adjust to the change and form new bone tissue faster, but this has its consequences - the new tissue is of poor quality, soft and can easily break.
Symptoms of Paget's disease
In most patients, no symptoms or complaints are observed for a long time. It is possible for the disease to go on for a long time without obvious manifestations, which is why it is possible to detect it at a later stage.
However, the most common complaint is bone pain. Its possible Paget's disease to affect one or more bones in a particular part of the body.
If the pelvis is affected - patients complain of pelvic pain, if the back is affected - back pain. If the disease has affected the bones of the legs, arthritis can develop, which is accompanied by the corresponding arthritis complaints. When the bones of the skull are affected, vision and hearing problems can develop.
Diagnosis of Paget's disease
During the examination by a specialist, the patient should tell in detail about their complaints. The doctor carefully examines those parts of the body that are very painful.
Tests are ordered to help make a more accurate diagnosis - blood tests and x-rays. X-rays reveal one or more bone deformities that are indicative of Paget's disease. Blood tests show an increased amount of phosphates.
Treatment of Paget's disease
If the patient has no complaints, then at the beginning it may not be necessary to prescribe specific treatment. In more advanced cases, however, it is mandatory to prescribe medication. Usually, medications prescribed for osteoporosis are also used to treat Paget's disease.
Most often, bisphosphonates and the hormone calcitinone are prescribed, which are most effective in back pain, bone fractures, headaches, hypercalcemia.
Calcitonin is administered subcutaneously, but certain complications may occur due to the body's resistance to it. Bisphosphonates, in turn, well limit bone destruction, most often taken for a period of half a year.
Nonsteroidal anti-inflammatory drugs may be prescribed for pain. Patients with Paget's disease also need increased intake of vitamin C and calcium.
In rare cases, surgical manipulation is performed, the purpose of which is to support the healing process in the bones and to overcome the fractures.
Patients usually have a high formation of new blood vessels in the affected bones, which causes heavy bleeding during operations in the area, which is the reason why surgery is rarely performed.
Complications of Paget's disease
Due to the improper formation of bone tissue, Paget's disease can cause malignant bone tumors. Osteosarcoma, fibrosarcoma and large tumor formations most often develop against the background of this disease. With the development of the disease, it is possible to experience very severe pain that does not respond to the prescribed treatment.
The article is informative and does not replace a consultation with a doctor!
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