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Treatment of Paget's Treatment of Paget's Disease Disease

Source: www.nmbonecare.com
Topic: Paget's disease of bone
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Sort Desciption: The disease begins in middle age or later . Affects most frequently the long bones of the lower extremities and the skull . The bones enlarge and soften, and those bearing weight yield and become unnaturally curved and misshappen. ...

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The disease begins in middle age or later . Affects most frequently the long bones of the lower extremities and the skull . The bones enlarge and soften, and those bearing weight yield and become unnaturally curved and misshappen. Sir James Paget 1876 Pathophysiology Pathophysiology Abnormal numbers and size of of osteoclasts and osteoclast Abnormal numbers and size of of osteoclasts and osteoclast nucleation nucleation primary defect primary defect Increase in bone resorption in affected site or sites Increase in bone resorption in affected site or sites Increased Bone Formation follows Increased Bone Formation follows secondary response: secondary response: Rapid formation leads to haphazard collagen deposition Rapid formation leads to haphazard collagen deposition Woven rather than linear bone Woven rather than linear bone Multiple cement lines Multiple cement lines Marrow develops fibrous tissue Marrow develops fibrous tissue Increased Increased vascularity vascularity Abnormal osteoid Abnormal osteoid A B Siris ES. Primer on Metabolic Bone Diseases and Disorders of Mineral Metabolism . 2003. Pagets Disease Prevalence Pagets Disease Prevalence In the U.S., prevalence is (estimated) to be 1.3 million In the U.S., prevalence is (estimated) to be 1.3 million 1.0% to 1.8% of people age 60 or older 1.0% to 1.8% of people age 60 or older 38K diagnosed and treated 38K diagnosed and treated Asymptomatic patients may be undetected or not Asymptomatic patients may be undetected or not treated treated Accurracy Accurracy of of survellance survellance detection may be incomplete detection may be incomplete Is prevalence changing, or are fewer patients being Is prevalence changing, or are fewer patients being screened and diagnosed? screened and diagnosed? ...

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