Understanding Paget's Disease: Key Information and Management
Paget's Disease is a focal skeletal disorder characterized by rapid bone remodeling, affecting older individuals with symptoms like bone pain, deformity, and arthritis. Learn about its epidemiology, clinical features, investigations, indications for therapy, and management strategies.
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Presentation Transcript
PAGETS DISEASE DR.APURVA AJANE (BHUTI) ASSISTANT PROFESSOR PRACTICE OF MEDICINE
It is a Focal skeletal disorder with rapid disorganized bone remodeling affecting one or more bones-characterized by increased bone turn over (osteoclastic activity) and increased but disorganized osteoid formation (osteoblastic activity).
Epidemiology 3% of population older than 50 years. Family history-15-30% Often affects pelvis, femur, spine and skull. Bone pain, deformity and degenerative arthritis Sometimes extensive multifocal involvement of many bones can occur. Enormously elevated serum alkaline phosphatase value as a result of increased bone turn over.
Clinical features Bone pain due to micro-factures Muscular strain and accelerated osteoarthritis. Joint deformitiy due to periarticular bone involvement. Enlargement of head-due to involvement of skull Reduction in height. Narrowing of cranial ostia and compression of cranial nerves.
Nerve root compression due to vertebral involvement Otosclerosis-hearing loss Hypercalcaemia and hypercalciuria with nephrolithiasis due to prolonged immobilization. High output cardiac failure-increased blood flow to the affected bones. Osteogenic sarcoma-Late complication and sudden accentuation of bone pain at a specific site denotes the possibility.
Investigations Serum alkaline phosphatase-Elevated X-Ray Local radiolucency-more commonly affecting one region of skull Osteoporosis circumscripta .
Indications for Therapy Bone pain due to Paget s disease. Nerve compression syndromes. Pathologic fractures. Progressive skeletal deformity. Immobilisation hypercalcaemia Asymptomatic involvement of weight-bearing bones and skull.
Management Adequate hydration and mobilization to avoid hypercalcaemia.
