What is Paget disease of the bone?

Paget disease of the bone is a chronic bone disorder. It causes bones to become enlarged and deformed. Bone may become dense, but fragile, because of excessive breakdown and deformation of bone. The disease is the most common bone disorder after osteoporosis in adults older than age 50.

What causes Paget disease of the bone?

The exact cause of Paget disease of the bone is unknown. It may be due to a slow viral infection of bone. Genetics may also play a significant role.

What are the symptoms of Paget disease of the bone?

These are the most common symptoms of Paget disease of the bone:

• Arthritis

• Bone deformity

• Pain

• Risk for bone fractures

Very rarely, Paget disease may progress to bone cancer.

The symptoms of Paget disease of the bone may look like other bone disorders or medical problems. Always talk with your healthcare provider for a diagnosis.

How is Paget disease of the bone diagnosed?

Your healthcare provider will review your medical history and do a physical exam. Other tests may include:

• Blood test. A blood test called serum alkaline phosphatase measures the levels of the enzyme alkaline phosphatase in the bone. Any condition of bone growth or an increased activity of bone cells, including Paget disease, will cause alkaline phosphatase levels to rise.

• Bone biopsy. These biopsies are sometimes done with a needle, using numbing medicine only or with sedation. Sometimes they are done in the operating room through small incisions. You may have a bone biopsy if an X-ray does not confirm or rule out the disease.

• Bone scan.  This nuclear imaging test uses a very small amount of radioactive material called tracer injected into the blood. This tracer can be found by a scanner. This test shows blood flow to the bone and cell activity within the bone.

• X-ray. This test uses invisible energy beams to make images of tissues, bones, and organs.

How is Paget disease of the bone treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Physical therapy to help muscle strength

• Medicines called bisphosphonates to slow abnormal bone resorption

• Medicines to manage pain

• Surgery to cut, realign, or replace affected bone

Key points about Paget disease of the bone

• Paget disease of the bone is a chronic bone disorder. It causes bones to become enlarged and deformed.

• It may be caused by a slow viral infection of the bone.

• Symptoms may include joint pain.

• Treatment may include physical therapy to help muscle strength and medicine to ease pain.

• Sometimes surgery is done to cut, realign, or replace affected bone.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.