Osteitis deformans

Disease class: Bone diseases

Also known as

•  Paget's disease of bone

This is a disease of bone metabolism.
After osteoporosis, this is the second most common bone disorder.
There is a wide range of severity. Most cases are identified by incidental diagnosis while investigating an unrelated disease.

 

Pathophysiology

There is increased osteoclastic activity and dysfunctional bone remodelling.

 

Causes

• Unknown

 

Risk factors

• Genetic factors
• Advanced age (10% of patients over 80 years old have Paget's disease of bone)

 

Symptoms

Paget's only causes symptoms in approximately 35% of patients at the point of first diagnosis.

• Bone pain 
• Headache
• Frequent bone fractures
• Leg bowing
• Hearing loss

 

Signs

• Deformity of the bones, especially the long leg bones, vertebral column (spine), pelvic bones, and skull bones
• Increased hat size
• Warmth of affected areas

 

Complications

• Osteoarthritis
• Heart failure (rarely seen in severe cases): occurs due to increasing systemic vascular resistance introduced by abnormal vascularity in the affected bones.

 

Epidemiology

• More common in men than women (3:2)
• Most common in patients with British ancestry
• Prevalence: 1.5 to 8.0% of the population

 

Management

• There is no curative treatment for this disease.
• The symptoms can be reduced with bisphosphonates and analgesics.
• Surgery may be helpful in some situations.