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Paget's Disease of Bone

A chronic skeletal disease with disrupted bone remodeling causing excessive and irregular resorption and formation.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Paget's Disease of Bone?

Paget's disease of bone is a chronic skeletal disorder of accelerated and disordered bone remodeling driven by hyperactive osteoclasts. The newly formed bone is large, fragile, and richly vascular. The pelvis, femur, tibia, skull, and lumbar vertebrae are typically involved.

It occurs in those over 50; incidence rises rapidly after 55. Genetic predisposition is important (e.g., SQSTM1 mutation). About 70% of patients are asymptomatic and the diagnosis is made on imaging done for other reasons or by detecting elevated alkaline phosphatase.

Complications include pathologic fractures, nerve compression, hearing loss (in skull involvement), heart failure (excess vascularization), and very rarely transformation to bone sarcoma.

Symptoms

Pain and warmth over affected bone
Bone deformities (bowing tibia — 'saber shin')
Headache and hearing loss in skull involvement
Pathologic fracture
Neurologic symptoms from nerve compression
Asymptomatic case: only elevated alkaline phosphatase

Risk Factors

Age over 60
Northern European or Anglo-Saxon ancestry
Family history of Paget's disease (SQSTM1 mutation)
Male sex (slightly more common)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When unexplained alkaline phosphatase elevation is found
  • When bone pain, deformity, or hearing loss develop together
  • If a pathologic fracture has occurred
  • In individuals over 40 with a family history of Paget's disease

Treatment Methods

01
Bisphosphonates: zoledronic acid 5 mg single IV dose (most potent and long-acting); oral alendronate as alternative
02
Treatment decision: symptomatic patients, skull/vertebral/hip involvement, or pre-surgery
03
Pain control: paracetamol or NSAIDs
04
Calcium and vitamin D support: alongside bisphosphonate therapy
05
Hearing follow-up: audiometry
06
Treatment response and recurrence assessment with alkaline phosphatase

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.