Paget’s Disease of Bone – Diagnosis and Treatment

Diagnosis

Imaging Methods

• X-ray images can show signs of Paget’s disease. Doctors often notice bone changes like unusual shapes, thickening, or curved bones in the legs or spine. These changes sometimes appear when X-rays are taken for other reasons.
• Bone scans use a safe radioactive substance. It travels through the bloodstream and highlights areas where bones are more active. These spots often match up with parts that Paget’s disease affects.

Blood and Lab Checking

Blood tests are common. Doctors look for higher levels of alkaline phosphatase in the blood. An increase often points to faster bone growth that happens with Paget’s disease.

Other blood tests help rule out problems that can look like Paget’s disease, such as infections or other bone conditions.

Additional Facts for Patients

• People may come to the doctor because of bone pain or unusual symptoms.
• The doctor may do a physical exam, checking for bone pain, changes, or possible fractures.

Treatment

Medicine-Based Approaches

Doctors usually suggest medicines for Paget’s disease if there are symptoms or if tests show the disease is active.

Bisphosphonates are the most common group of medicines that slow down bone changes. Some of these drugs are given by mouth, while others are given through a vein (IV).

Oral bisphosphonates are simple to take but may upset the stomach. IV bisphosphonates can be more convenient for some people as they are given less often.

While helpful, these drugs can sometimes cause strong bone, muscle, or joint pain. Rarely, they can lead to jaw problems, especially after dental surgery.

If bisphosphonates don’t work for someone, doctors may prescribe calcitonin. This hormone, given by injection or nasal spray, helps control bone activity.

Common side effects are nausea, redness of the face, and soreness where the shot was given. Doctors may also recommend over-the-counter pain medicines like acetaminophen, naproxen, or ibuprofen to help with discomfort.

Operations and Surgical Solutions

Doctors may recommend surgery when bones are badly damaged. Surgeons can fix broken bones, replace joints, reset bones that have changed shape, or take pressure off nerves.

Since Paget’s disease can cause extra blood vessels in the bones, patients may face a higher chance of heavy bleeding during operations. Doctors sometimes give medicine before surgery to help lower this risk and make the surgery safer.

Surgeons may use osteotomy to straighten bones. Joint replacement might be necessary for those with severe joint damage from the disease. Doctors carefully plan each surgery, especially when Paget’s disease affects the bones.

Taking Care of Yourself

Staying safe and healthy with Paget’s disease of bone means making everyday adjustments.

Self-Care Focus	Actions
Home safety	Remove tripping hazards, add handrails
Physical activity	Low-impact exercise, physical therapy
Nutrition	Get enough calcium and vitamin D
Fall prevention	Use canes or walkers if needed
Managing pain	Relaxation methods, speak to a doctor
Hearing monitoring	Checkups if hearing problems occur

To lower the chance of bone fractures, make the home safer by removing rugs that slide easily, using nonslip mats in bathrooms, moving electrical cords out of walking paths, and adding handrails or grab bars on stairs and in bathrooms.

Using aids like a cane can help reduce falls, especially if a person feels unsteady or dizzy. Simple exercises, chosen with guidance from a healthcare provider, may help maintain muscle strength and joint movement.

Activities such as walking or gentle stretching can also support pain management.

Eating right supports bone health. A balanced diet with plenty of calcium and vitamin D is necessary, particularly for people taking certain medicines like bisphosphonates. Some may need supplements; a doctor or nutritionist can help decide.

Other tips include working with a physical therapist and using relaxation techniques to handle discomfort. Hearing loss is sometimes linked to Paget’s disease, so regular check-ups for hearing changes are useful.

Getting Ready for Your Visit

Steps You Can Take Before Your Visit

Being well prepared can help you get the most out of your appointment.

• Check with the clinic. When scheduling, ask if you need to do anything special, like fasting for a blood test.

• Write down your symptoms. List all symptoms, even if they don’t seem related. This information is helpful for the doctor.

• Gather personal and family details. Note any major stress, recent life events, or family medical history.

• List your medications. Include all prescription medicines, over-the-counter drugs, vitamins, and supplements, along with their dosages.

• Prepare questions. Have a set of questions ready for your doctor. Some examples:

  • What might be causing my symptoms?

  • Are there other possible reasons?

  • What tests do I need?

  • Is my condition temporary or ongoing?
  • What treatment do you recommend?
  • Are there other options?
  • How can I manage this along with my other health issues?
  • Are there any restrictions?
  • Should I see a specialist?

• Bring support. Having a family member or friend with you can help you remember details and feel more at ease.

• Ask all questions. Do not hesitate to speak up if anything is unclear or if you think of new questions.

What the Doctor Might Ask You

The doctor will likely have a series of questions to better understand your situation. Typical questions include:

• Have you noticed numbness or tingling in any part of your body?
• Are you experiencing muscle weakness?
• Have you developed any new headaches?
• Has there been any recent change in your hearing?

The doctor may also ask about specific symptoms, your medical history, your family’s medical background, and any previous test results. It is helpful to answer these questions as honestly and clearly as possible, even if the information seems minor.

Tip: Bringing a written list of your symptoms and timeline can help you give clear answers. Health professionals use your answers and the information you provide to decide the best tests and create a treatment plan.

Quick Reminders:

• Review your medication list before your visit.
• Take notes during the appointment, or ask your companion to do so.

Organizing your information and being open during the conversation can make your visit more productive and help you get the care you need.

Additional Details

Paget’s disease is a long-term bone disorder that causes bones to grow larger and weaker than normal. This condition can sometimes be mistaken for osteoporosis, but they are different problems.

People with Paget’s disease can have bone pain, bent bones, or joints that do not work well.

Common Risk Factors:

• Age: Most cases happen in people over 50.
• Genetics: Having a family member with the disease raises risk.
• Ethnicity: Those of European descent are more likely to have it.

Possible Complications:

• Misshapen bones
• Joint problems such as arthritis
• Fractures or broken bones
• Hearing loss (if skull bones are involved)
• High calcium levels in the blood (rare)

Condition	How It’s Different from Paget’s Disease
Osteoporosis	Bones become thin and fragile, not enlarged.

Researchers do not know exactly what causes Paget’s disease, but it may include both genetic and environmental parts. It is not very common, and only a small part of the population gets it.