Paget's Disease of Bone: Diagnosis and Treatment - 29/10/18
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Abstract |
Paget's disease of bone is a common bone disorder characterized by disorganized bone remodeling. The most likely etiology is a slow paramyxoviral infection in genetically susceptible individuals; however, the exact cause is unknown. Enhanced bone resorption due to an increased activity of osteoclasts recruits numerous osteoblasts to resorption sites, with large quantities of new bone matrix produced as a result. The accelerated bone resorption and formation are not as closely coupled as in a healthy bone; a disorganized bone tissue is formed. Many patients are asymptomatic; rising serum alkaline phosphatase or incidental finding of characteristic radiographic lesions are often the only diagnostic clues. Common clinical manifestations include bone pain, bowing of long bones, enlarged skull, and hearing loss. An elevated serum alkaline phosphatase level correlates with the disease activity. The diagnosis is confirmed by characteristic radiographic findings and by nuclear scintigraphy of the bone (the most sensitive test). Bisphosphonates, such as zoledronic acid, pamidronate, alendronate, and risedronate, are the mainstay of treatment. Patients who do not tolerate bisphosphonates can be treated with calcitonin.
Le texte complet de cet article est disponible en PDF.Keywords : Bisphosphonates, Osteitis deformans, Osteoclasts, Paget's disease of bone
Plan
Funding: None. |
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Conflict of Interest: None. |
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Authorship: The author is solely responsible for the content of this manuscript. |
Vol 131 - N° 11
P. 1298-1303 - novembre 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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