Definition

Paget disease (PD) is a bone disorder. Normal bone is always being broken down and built again. With PD, bones are broken down too fast. New bone is loose and bulky instead of strong and compact. This leaves bones weak. They may bend over time. Early treatment can improve outcomes.

PD affects the bones of the:

  • Pelvis
  • Legs
  • Skull
  • Spine

Normal Bone Structure
Bone Matrix

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Causes

The exact cause is not known. It may be due to a viral infection, such as the measles.

Risk Factors

PD is more common in people who are over 55 years of age. It usually happens in people of European descent.

Other things that may raise the risk are:

  • A faulty SQSTM1 gene
  • Having a family member with PD, such as a parent, sibling, or child
  • Tobacco use

Symptoms

Most people do not have symptoms. Those who do may have:

  • Bone and joint pain
  • Bones that do not look the way they should
  • Problems hearing

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood tests will be done.

Images will be taken of your body. This can be done with:

Treatment

There is no cure. The goal of treatment is to manage symptoms. Choices are:

  • Medicines, such as:
    • Pain relievers, such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs)
    • Bisphosphonates to prevent the loss of bone and keep the disease from getting worse
  • Calcium and vitamin D supplements
  • Assistive devices, such as canes and shoe lifts

People who are not helped by these methods may need surgery to realign bones.

Prevention

There are no known ways to prevent this health problem.

RESOURCES:

NIH Osteoporosis and Related Bone Diseases National Resource Center
http://www.niams.nih.gov

The Paget Foundation
http://www.paget.org

CANADIAN RESOURCES:

The Arthritis Society
http://www.arthritis.ca

Osteoporosis Canada
http://www.osteoporosis.ca

REFERENCES:

Paget disease of bone. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/paget-disease-of-bone. Accessed March 12, 2021.

Paget's disease of bone overview. NIH Osteoporosis and Related Bone Diseases National Resource Center website. Available at: https://www.bones.nih.gov/health-info/bone/pagets/patient-info. Accessed March 12, 2021.

Singer FR, Bone HG 3rd, et al. Paget's Disease of Bone: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2014 Dec;99(12):4408-4422.

Last reviewed December 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD