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Paget's Disease

What is Paget's disease?

Paget's disease of bone (also known as medical titles: osteitis deformans, osteo deformans, deforming osteodystrophy) occurs when the bone is damaged recovery mechanism of the body.

Bone - living tissue that constantly breaks down and rebuilt, a process called "bone remodeling". In bone affected by Paget's disease, impaired remodeling process that leads to disruption of the structure or architecture of bone, the bone is not restored properly, forming a "weak" bones that are deformed, restretch, bent and prone to fractures.

Paget's disease can occur in any bone of the body. One-third of affected patients, only one bone, but the average number of damaged bones - about three. The bones most often involved in the process of the pelvis, spine, skull and long bones of hands and feet.
Up to 3% of people of European origin older than 40 years affected by Paget's disease, and prevalence increases with age. The disease occurs twice as often in men than in women.

Causes of Paget's disease

Causes of Paget's disease is still unknown.

The most common opinion about the viral nature of the disease (slow virus infection). A sick person can be for many years, carry the virus without any symptoms of the disease, after which the result of exposure to trigger factors symptoms. One of the most important viral infection is measles.

Also, do not exclude the role of genetic predisposition. It is believed that Paget's disease to some extent, runs in families. It is therefore recommended that the brothers, sisters and children of patients with Paget's disease donated blood chemistry every two to three years to control the level of alkaline phosphatase in the blood, and if necessary X-rays of bones did.

These reasons are not mutually exclusive.

Symptoms

Symptoms of Paget's disease depends on the damaged bone and the severity of the disease.

Symptoms of Paget's disease include pain around the damaged bone and osteoarthritis if the disease occurs around joints bones. The pain associated with broken bone in Paget's disease, is usually described as a continuous, dull, aching, and in contrast to osteoarthritis, is often amplified at rest and after rest. Stiffness, limited mobility in the affected joints and worse after rest.

The bones in various parts of the body are very thick and brittle, leading to the destruction of the bones that support your body weight. Fractures can occur even with light injuries, the back is hunched and deformed, bent legs.

Abnormal growth of bones of the skull, in which there is a characteristic appearance of the head and spine can put pressure on surrounding nerves, the damage which can cause serious consequences such as permanent loss of hearing or vision, headaches, nerve damage or spinal cord, causing tingling and numbness in arms and legs, a feeling of "pins and needles" in the body. In very rare cases, severe Paget's disease can cause heart failure or malignancy (malignancy) process with the development of bone tumors.

Diagnosis of disease

X-ray and blood test for serum alkaline phosphatase, which is formed by the process of bone remodeling, are used to diagnose the disease. The level of serum alkaline phosphatase is often much higher than normal. Regular blood tests are needed to monitor any changes. Bone scintigraphy of the skeleton is important in establishing the exact location of bone, it provides a visualization of the entire skeleton.

Treatment of Paget's disease

Treatment of Paget's disease is aimed at controlling disease activity and preventing complications.

Paget's disease treated with drugs called bisphosphonates. They slow down the process of remodeling of the bone defect and may reduce disease activity for many months or years, even after it stopped taking medication. Treatment does not cure the disease, but may provide long-term remission (reduction of disease activity). Courses of tablets usually last six months, and treatment can be repeated if relapse occurs. These medications can cause side effects from the stomach and internal organs, such as irritation of the stomach and heartburn, as muscle or joint pain and headaches.

It is important to take each medication exactly as prescribed.

For pain control using nonsteroidal anti-inflammatory drugs (known as NSAIDs) such as paracetamol. People with Paget's disease also need an adequate intake of calcium and vitamin D, and individualized exercise programs to help prevent further damage to the involved bone.

Surgical assistance may be needed to address the treatment of bone fractures or arthritis, joint replacement (endoprosthesis replacement).

When hearing loss use hearing AIDS.

What can you do?

If you notice in yourself or your family changes described above, should immediately contact a doctor. Because the disease is unpredictable, it can flow a long time without any serious consequences, and could result in a few months to a disability, you need as soon as possible to begin treatment. Self-treatment is just as dangerous as not treating the disease. Therefore, without consulting your doctor does not try to heal themselves.

What can a doctor?

The doctor will do tests necessary for accurate diagnosis. After determining the stage of the disease, he will appoint the necessary treatment, including medication, special exercises to strengthen the skeletal system.

The prognosis for uncomplicated favorable. Patients should be followed up by observation of a podiatrist.