Paget’s Disease Of The Bone : Tests & Treatment
Paget’s disease is a disorder that involves abnormal bone destruction and regrowth, which results in deformity.
The excessive breakdown and formation of bone tissue causes affected bone to weaken, resulting in pain, misshapen bones, fractures, and arthritis in the joints near the affected bones.
Paget’s disease typically is localized, affecting just one or a few bones, as opposed to osteoporosis, for example, which usually affects all the bones in the body.
Tests & Diagnostics
Tests that may indicate Paget’s disease include:
1. Bone scan
2. Bone x-ray
3. Elevated markers of bone breakdown (for instance, N-telopeptide)
4. Elevated serum alkaline phosphatase
This disease may also affect the results of the following tests:
(a) ALP (alkaline phosphatase) isoenzyme
(b) Serum calcium
Not all patients need treatment. For example, patients who have abnormal blood tests only may not need treatment.
People with Paget’s disease who are commonly treated include:
1. Patients with deformities
2. Patients with no symptoms when certain bones (such as weight-bearing bones) are involved, especially if the bony changes are progressing quickly, to reduce the risk of fractures
3. Patients with symptoms
Drug therapy helps prevent further bone breakdown. Currently, there are several classes of medications used to treat Paget’s disease. These include:
1. Bisphosphonates — These drugs are the first-line treatment, and they help increase bone density. Types of bisphosphonates include:
a. Alendronate (Fosamax)
b. Etidronate (Didronel)
c. Pamidronate (Aredia)
d. Risedronate (Actonel)
e. Tiludronate (Skelid)
f. Zoledronic acid (Zometa)
2. Calcitonin — This hormone is involved in bone metabolism. Types include:
3. Plicamycin (Mithramycin)
Analgesics or nonsteroidal anti-inflammatory medications (NSAIDs) may also be given for pain.
Localized Paget’s disease needs no treatment, if there are no symptoms and no evidence of active disease. Orthopedic surgery may be needed to correct a deformity in severe cases.
Paget’s disease is most often treated with drug therapy, with bone pain lessening within weeks of starting the treatment. While non-steroidal anti-inflammatory drugs can reduce bone pain, two additional categories of drugs are used to treat this disease.
HORMONE TREATMENT. Calcitonin, a hormone which is made naturally by the thyroid gland, is used to treat Paget’s disease.
BISPHOSPHONATES. The bisphosphonate group of drugs are drugs that bind directly to bone minerals because of their specific chemical structure.