Summary
Definition
History and exam
Other diagnostic factors
- femoral, pelvis, and/or skull involvement
- long-bone or back pain
- pathological fracture
- bony deformities (e.g., frontal bossing, prognathism, bone bowing)
- increased local temperature
- hearing loss
- facial pain
- loosening teeth or disturbance in chewing
- deterioration of visual acuity
Risk factors
- family history of Paget's disease
- age >50 years
- male sex (45- to 74-years age group)
- infection
- environmental factors
Diagnostic investigations
1st investigations to order
- plain x-ray
- bone scan
- total serum alkaline phosphatase
- bone-specific alkaline phosphatase
- serum calcium
- serum procollagen 1 N-terminal peptide (P1NP)
- serum C-terminal propeptide of type 1 collagen (CTX)
- LFTs
- serum 25-hydroxyvitamin D
Treatment algorithm
Contributors
Authors VIEW ALL
Associate Physician
Assistant Professor of Medicine
Brigham and Women's Hospital
Department of Orthopaedics and Medicine/Rheumatology
Boston
MA
Disclosures
JFC has received royalties from Up To Date, Waltham, MA, for authorship on articles relating to Paget disease of bone (PDB). JFC has also received grant funding from the NIH, Rheumatology Research Foundation and Brigham and Women's Hospital for research into regulation of osteoclast function, but not specifically relating to PDB. JFC has had a manuscript published from a collaboration with Dr. Jae Shim describing a Pagetic phenotype in mice with osteoclast-specific loss of Chmp5.
Dr Julia F. Charles would like to gratefully acknowledge Dr Camilo Restrepo and Dr Javad Parvizi, previous contributors to this topic. CR and JP are authors of references cited in this topic.
Peer reviewers VIEW ALL
Director
Endocrine/Bone Disease Program
John Wayne Cancer Institute
Santa Monica
CA
Disclosures
FS declares that he has no competing interests.
Orthopaedic Surgeon
Hospital for Special Surgery
New York
NY
Disclosures
JL declares that he has no competing interests.
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