Paget’s Disease: Symptoms, Diagnosis & Treatment

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Paget’s Disease of the Bone affects almost 10% of the world’s population. It is a common metabolic bone disorder in adults over 50, especially males. Bone production in a person with Paget’s Disease is accelerated, making the bones brittle. These bones are weak and breakage-prone and may cause discomfort and pain. There is currently no cure for Paget’s Disease, but there are treatments available. Find out the symptoms, diagnosis, and treatment options in this article.

Symptoms of Paget’s Disease

Paget’s Disease affects about a tenth of the world’s population. It is predominantly found in adults over 55 and rarely diagnosed in those under 40. It occurs more frequently in men and people of European descent, including North Americans, Canadians, and Australians. However, it is rare in Scandinavians, Asians, and Africans. Many people with the disease are asymptomatic. However, when they show symptoms, they often experience pain.

Paget’s Disease usually manifests in the pelvis, lumbar spine, femur, thoracic spine, and skull. It can affect one or more bones in the body, resulting in osteoarthritis, bone deformities, heart failure, and neurological problems. Physical symptoms include bone pain, loose teeth, headache, hearing loss, hip pain, and kidney stones. The cause of Paget’s Disease is unknown, but genetics play a significant role.

Diagnosis of Paget’s Disease

Paget’s Disease is often found by chance. Medical practitioners will likely discover it when they request X-rays for other complaints, such as hip or back pain. After inquiring about the patient’s past health, the doctor will run some physical tests. The patient will undergo more exams, such as a bone scan, x-ray, or blood test. Blood tests reveal the presence of the disease because Paget’s Disease usually causes elevated levels of alkaline phosphatase in the blood.

Treatments for Paget’s Disease of Bone

Many people with Paget’s Disease don’t require treatment, including those without elevated alkaline phosphatase levels. Asymptomatic people, anyone not at risk of being affected in high-risk areas (e.g., spine), and those without active disease progression may not require treatment. However, multiple options are available for those needing Paget’s Disease treatment.

Bisphosphonates

Bisphosphonates are a leading medication for those with Paget’s Disease. It can be administered intravenously or orally. Intravenous Bisphosphonates include Zoledronic acid (Zometa, Reclast), Pamidronate (Aredia), and Ibandronate (Boniva). Oral bisphosphonates include Alendronate (Fosamax, Binosto) and Risedronate (Actonel, Atelvia).

Zoledronate (Zoledronic acid) is the most effective and is usually the first line of treatment for Paget’s Disease. A single intravenous dose is enough to keep the disease in remission for prolonged periods. Using Bisphosphonates can lead to side effects like jawbone and dental issues or joint pain. Some people may also react negatively to Bisphosphonates. Calcitonin is administered instead of Bisphosphonates for those who react negatively to it.

Surgery

Patients with Paget’s Disease might require surgery to fix some deformities. These situations are rare, though, and only happen when medications cannot treat the problem. Doctors may recommend surgery to correct deformed bones (e.g., bow legs) or repair unstable fractures. Surgery is also used to remove pressure from nerves and replace damaged joints. Knee or hip replacements may also be required for some patients with Paget’s Disease.

Conclusion

The occurrence and severity of Paget’s Disease have reduced over the years. However, it remains the second most common bone disorder in the world after osteoporosis. Thankfully, the treatment options available have proved effective so far. More advancements are also being made to improve their efficacy. Therefore, you can visit your doctor for a diagnosis if you suspect that you have this disease.

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Originally written by Chukwudi Onyewuchi