Title

The evaluation and treatment of Paget's disease of bone.

Document Type

Article

Publication Date

4-11-2020

Publication Title

Best practice & research. Clinical rheumatology

Abstract

Paget's disease of bone is a localized skeletal disorder, which is more common in England and in countries to which the English migrated. In recent decades, the prevalence in most countries has decreased. A family history of the disorder is present in approximately 15% of patients. Patients may be asymptomatic and may be diagnosed accidently as a consequence of an elevated serum alkaline phosphatase level or a finding on an x-ray or nuclear bone scan. The diagnosis is made by x-ray but nuclear bone scans define the extent of the disease. Salmon calcitonin and bisphosphonate drugs have proven effective, but by far, the most effective therapy is a single 5 mg intravenous infusion of zoledronic acid. This can normalize alkaline phosphatase levels for up to 6.5 years. A variety of gene mutations may predispose individuals to develop the disease but environmental factors such as measles virus likely play an important role.

Clinical Institute

Orthopedics & Sports Medicine

Department

Orthopedics

Department

Endocrinology

Department

Surgery

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