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Paget disease of the bone

Osteitis deformans

Paget disease is a disorder that involves abnormal bone destruction and regrowth. This results in deformity of the affected bones.

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Causes

The cause of Paget disease is unknown. It may be due to genetic factors, but also could be due to a viral infection early in life.

The disease occurs worldwide, but is more common in Europe, Australia, and New Zealand. The disease has become much less common over the last 50 years.

In people with Paget disease, there is an abnormal breakdown of bone tissue in specific areas. This is followed by abnormal bone formation. The new area of bone is larger, but weaker. The new bone is also filled with new blood vessels.

The affected bone may only be in one or two areas of the skeleton, or in many different bones in the body. It more often involves bones of the arms, collarbones, legs, pelvis, spine, and skull.

Symptoms

Most people with the condition have no symptoms. Paget disease is often diagnosed when an x-ray is done for another reason. It may also be discovered when trying to find the cause of high blood calcium levels.

If they do occur, symptoms may include:

Exams and Tests

Tests that may indicate Paget disease include:

This disease may also affect the results of the following tests:

Treatment

Not all people with Paget disease need to be treated. People who may not need treatment include those who:

Paget disease is commonly treated when:

Drug therapy helps prevent further bone breakdown and formation. Currently, there are several classes of drugs used to treat Paget disease. These include:

Acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) may also be given for pain. In severe cases, orthopedic surgery may be needed to correct a deformity.

Support Groups

People with this condition may benefit from taking part in support groups for people with similar experiences.

Outlook (Prognosis)

Most of the time, the condition can be controlled with medicines. A small number of people may develop a cancer of the bone called osteosarcoma. Some people will need joint replacement surgery.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of Paget disease.

Related Information

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Spinal stenosis

References

Ralston SH. Paget disease of bone. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 247.

Singer FR. Paget's disease of bone. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 72.

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Review Date: 11/17/2017  

Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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