Paget's Disease

            
             Paget's disease, also called Osteitis deformans, is a disease in which excessive bone breakdown and abnormal bone formation occurs. The disease occurs worldwide, but is more common in Europe, Australia, and New Zealand where it is seen in up to 5% of the elderly population. Most people with Paget's disease are over the age of 40.
             Many patients discover they have Paget's disease inadvertently during an unrelated X-ray. It can also be diagnosed through a bone scan, an elevated presence of serum alkaline phosphates in the body, or elevated markers of bone breakdown such as N-telopeptide. The symptoms of Paget's disease can be severe and persistent bone pain, joint pain, joint stiffness, headache, bowing of the legs, warmth of the skin overlying the affected bone, easily fractured bones, neck pain, reduced height, and possibly hearing loss if the disease effects the area around the ears. Some patients have no apparent symptoms.
             Paget's disease may be caused by a viral infection and genetic factors in theory. The disease causes the new formation of Pagetic bone. The new bone is structurally enlarged, but weakened and filled with new blood vessels. It may be confined to one or two areas within the skeleton or become widespread. The pelvis, femur, tibia, vertebrae, clavicle, and humerus are the most effected bones. Complications of the disease can be deafness, spinal stenosis, deformities, bone fractures, paraplegia, or cardiac failure.
             Paget's disease can be treated with several classes of medication such as bisphosphonates, calcitonin, or plicamycin. Bisphosphonates are the first line of defense. They include etidronate (Didronel), alendronate (Fosamax), pamidronate (Aredia), tiludronate (Skelid), and risedronate (Actonel). The calcitonin and plicamycin classes can include Miacalcin or Mitrhracin as a more aggressive treatment. Surgery may be performed to correct deformed bones in severe cases.