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Paget disease of the bone

Osteitis deformans; Paget's disease of the bone

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 or hypersensitivity to vitamin D.

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 or fracture.

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

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

Related Information

Hearing loss
Spinal stenosis

References

Geiger CD, Devereaux MW, Hart D. Disorders of bones, joints, ligaments, and meninges. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 104.

Ralston SH. Paget disease of bone. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 228.

Singer FR. Paget disease of bone. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 63.

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Review Date: 10/29/2023  

Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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