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Last Updated: Oct 23, 2019
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Paget's Disease Of The Bones - Diagnosis and Treatment!

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Dr. Sanjib Kumar BeheraOrthopedic Doctor • 36 Years Exp.MS - Orthopaedics, MBBS Bachelor of Medicine and Bachelor of Surgery, DNB - Orthopedics & Orthopedic Surgery
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The bones in our body are constantly renewing themselves. The old bone tissue is broken down and absorbed by the body while new tissue takes its place. This process is known as 'remodeling'. Paget's disease is a condition that interferes with this process. Over time it can lead to the disfiguring of bones and a loss of bone density. The bones most affected by this condition are the bones of the legs, spine, pelvis and skull.

Diagnosis
Many patients suffering from this condition do not exhibit any characteristic symptoms. One of the most common complaints that can lead to a diagnosis of Paget’s disease is bone pain. Other symptoms, if any, depends on the part of the body that is affected. A physical examination and imaging tests help determine a diagnosis in such cases. This includes X-rays, bone scans and blood tests. X-rays are used to look for abnormalities in the bone structure. These can be seen in the form of enlarged bones, bowing of the bones or other deformities. Similarly, a bone scan provides a clear picture of the affected bones and allows the doctor to determine the severity of the case. Blood tests are used to look for elevated alkaline phosphatase levels that are also symptomatic of this condition.

Treatment
There are two aspects to the treatment of this condition; medication and surgery.

Medication can take the form of oral or injectable osteoporosis drugs. These are usually well tolerated but in some cases, it may irritate the digestive system. In rare cases, it may also be connected to joint pain and muscle pain. It may also increase the risk of suffering from deterioration of the jaw bone. In such cases, the medication is usually withdrawn and calcitonin may be prescribed as an alternative. This can be administered as a nasal spray or as an injection.

Surgery is advised only in rare cases. This is aimed at healing fractures, replacing damaged joints, realigning deformed bones and reducing pressure on surrounding nerves. Before the patient undergoes surgery for Paget’s disease, he or she may be advised to take a certain medication that helps reduce the severity of the disease. This, in turn, helps control blood loss during the surgery.

In addition to this, patients are also advised to be careful and use a cane or walker. This can help reduce the risk of fracturing a bone. A diet rich in vitamin D and calcium is also recommended.

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