What should people diagnosed with Paget’s disease know?

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Paget’s disease causes weakness of the bones secondary to a defect in the normal recycling process in the body whereby the new bone replaces the old bone. Consequently, there is misshaping of the bones, with increased fragility. The bones commonly affected include: pelvis, legs, spine and skull. Bone doctors like Best Orthopedic Surgeon in Karachi need to evaluate the patient to ensure there are no related disorders. Read on to know more about Paget’s disease.

What isPaget’s diseased?

The chronic disorder of Paget’s disease involves enlarged but weakened bones due to excessive resorption and deposition of bone matrix that fails to maintain its strength. Paget’s follows a three-phase process: initiating with intense osteoclastic or bone-breaking activity of osteoclasts. During this phase the bones resorb at twenty times the normal rate. This is follow by the osteoblastic activity in which new bone is laid down. However, this bone is ineffectively lai and the mineralization is feeble.   

In majority of cases of Paget’s disease, axial skeleton is affect with involvement of at least two bones, like the pelvis and lumbar spine. In one-third of cases, only one bone is impact by Paget’s disease.  

What are the causes of Paget’s disease?

The exact cause of Paget’s disease is not understo yet. The hypothesized etiological factors are: hereditary, environmental and viral causes. Researchers have identified genes that increase the odds of developing Paget’s disease. In as many as 40 percent of cases of Paget’s disease, a positive family history has found. Some studies have also found viral antigens inside the bone-resorbing osteoclasts responsible for the first phase of Paget’s disease.

How is Paget’s disease diagnose?

Paget’s disease is mostly diagnose when all other causes of bone pain have been ruled out. In an estimate 70 percent of cases, there are no symptoms, and the diagnosis is made accidently.

Some common investigations for Paget’s disease include:

X-rays: this is the most common investigation for bone disorder like Paget’s disease. Healthcare providers use x-rays to evaluate the bone structure and rule-in Paget’s. Mostly, the radiographs show lytic and sclerotic findings.

Blood tests: the serum alkaline phosphatase (SAP) level in Paget’s disease patients is high because of the rapid bone turnover. Serum alkaline phosphatase levels are also use to diagnose asymptomatic people with positive family history. In case of high alkaline phosphatase, bone scan is performe to find the extent of disease.  

Bone scan: this detailed test helps healthcare providers localize the bones affected by Paget’s disease; these scans also determine the extent of disease. During the test, a small amount of radioactive dye is injecte in the vein which travels to the bone-forming cells and ‘highlights’ these regions. These highlighted regions are characteristic of Paget’s disease.

What is the management of Paget’s disease?

The treatment of Paget’s disease provides a degree of remission only, but no cure. During these periods of remission, the disease activity stays low and bone resorption slows. Drugs like bisphosphonates are use to treat Paget’s, which inhibit the osteoclasts. Treatment is recommendfor people with high biomarkers like alkaline phosphatase and involvement of weight-bearing joints.

Another type of drug called calcitonin slows osteoclastic bone activity, slowing the resorption of bone. It is available in injectable and nasal spray form.

Patients are also given adequate doses of vitamin D and calcium every day and advise to exercise daily to strengthen the bones. In rare cases, surgical treatment is need, for joint replacement. More information for treatment can find on oladoc.com.

Uneeb Khan

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