Paget’s Disease Of Bone Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Paget’s Disease Of Bone is characterized by excessive release of calcium from the bones. This causes bones to become brittle and break easily.
There are two main types of cells in human bones, namely osteoblasts and osteoclasts. Osteoblasts are cells that work to keep the bone structure strong and not easily broken. To be balanced, osteoclasts work to take calcium from the bones to be circulated into the blood. If osteoblasts and osteoclasts are in normal condition, you will get dense bones and normal blood calcium levels.
In Paget’s bone, osteoclasts actually do an excessive activity. As a result, too much calcium is released from the bones so that the bones become more brittle.
This disease was first discovered by a surgeon from England named Sir James Paget. Therefore this disease is called Paget’s bone. Previously, Paget’s disease was known as osteitis deformans.
Paget’s disease of bone is more common in Europe, North America, Australia and New Zealand. Meanwhile, Asian and African people rarely experience this disease.
Symptoms
About 70–90 percent of Paget’s bone cases are asymptomatic. However, there are a small number of sufferers who feel complaints such as:
- Bone pain
- Osteoarthritis (the cartilage in the joints wears away)
- Crooked or shortened bones
- The bone area affected by Paget’s disease will feel warmer when touched
- Nerve disturbances such as tingling, pain, or difficulty moving if the Paget bone causes nerve compression
Paget’s disease of bone usually affects several bones. The bones that are often affected are the spine, femur, and skull. Some cases of Paget’s bone can also turn into cancer.
If Paget hits the skull, complications can occur, such as:
- Hearing loss
- Vertigo
- Ringing or buzzing ears
- Teeth can not be closed
- There are neurological disorders such as a slanted mouth, slurred speech, squint, and so on
Reason
The cause of Paget’s bone is not known with certainty. However, it is suspected that a combination of genetic and environmental factors play a role in causing Paget’s disease.
Several genes that contribute to the occurrence of Paget’s disease are the SQSTM1, VCP, and OPTN genes. Meanwhile, environmental factors that are thought to play a role are a history of previous bone disease and a previous viral infection.
Diagnosis
If the doctor suspects that someone has Paget bone, then an alkaline phosphatase examination will generally be carried out. Those who have Paget’s disorder of bone, their alkaline phosphatase will increase. In addition, urine tests can help determine the cause of Paget’s. The presence of hydroxyproline in the urine supports the diagnosis of Paget’s disease.
When an X-ray is taken of the affected bone, it will appear that the bone with Paget’s disease looks less dense. If there are also symptoms of nerve compression, generally a CT scan or MRI examination also needs to be done.
Treatment
Paget’s disease of the bone can’t be completely cured, but the condition can be controlled. To prevent bones from becoming brittle, drugs will be given to increase bone density. Usually, sufferers receive bisphosphonate-type drugs, plus calcium and vitamin D.
If there is a disturbance of standing or walking posture, the patient may need an assistive device to walk. For example by using a walker.
Patients with Paget bone are also considered susceptible to cancer. Therefore, sufferers must undergo regular control to the doctor for a thorough check, including early detection if a tumor is found. If the tumor is known to be malignant, then generally chemotherapy and radiation need to be done.
Prevention
Until now there is no action that can prevent Paget’s disease. However, early detection measures can be taken. Early detection should be done in those who have a family history of Paget’s disease of bone. With this history, for early detection, someone should have their alkaline phosphatase levels checked.