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Paget's Disease
Paget's disease is a relatively common form of localized bone disease. Paget's is sometimes referred to as osteitis deformans due to it's ability to cause bone deformities in some cases. The cause of Paget's disease is unknown but has in the past been postulated to be caused by a genetic defect of metabolism. Recent theories have suggested Paget's to be secondary to a viral infection. Incidence of Paget's is approximately 3% of the population over age 40 and 10% of the population over age 70. Many patients with Paget's disease are totally asymptomatic during the course of their disease. Paget's is characterized by coarse, thickened bone tissue (as seen on x-ray), altered bone growth and destruction of the bone marrow (fibrosis). The skull, tibia, femur, pelvis, and spine are most often affected. Patients with Paget's can suffer from headaches, intermittent ringing in the ears, vertigo, and hearing loss. Bone pain in the spine, pelvis, hips, and legs is not uncommon. Secondary degenerative arthritis in the knee joints is also seen. Diagnosis is made by x-ray of the skull, spine, or extremities. Patients with Paget's will also have elevation of their alkaline phosphatase enzyme in their bloodstream. Blood calcium levels may be normal to elevated. Treatment of Paget's includes calcitonin (parathyroid hormone) therapy and mithramycin treatment.
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