The evaluation and treatment of Paget's disease of bone. Issue 3 (June 2020)

• Record Type: Journal Article
• Authors: Singer, Frederick R.
• Is Part Of: Best practice & research. Volume 34:Issue 3(2020:Jun.)
• Publication Date: 2020-06
• Subjects: Bone pain -- Deformity -- Familial -- Drug therapy -- Surgery; Rheumatology -- Periodicals; Rheumatic Diseases -- Periodicals; Reumatologie; 616.723005
• DOI: 10.1016/j.berh.2020.101506
• Languages: English
• ISSNs: 1521-6942

Abstract

Abstract: Paget's disease of bone is a localized skeletal disorder, which is more common in England and in countries to which the English migrated. In recent decades, the prevalence in most countries has decreased. A family history of the disorder is present in approximately 15% of patients. Patients may be asymptomatic and may be diagnosed accidently as a consequence of an elevated serum alkaline phosphatase level or a finding on an x-ray or nuclear bone scan. The diagnosis is made by x-ray but nuclear bone scans define the extent of the disease. Salmon calcitonin and bisphosphonate drugs have proven effective, but by far, the most effective therapy is a single 5 mg intravenous infusion of zoledronic acid. This can normalize alkaline phosphatase levels for up to 6.5 years. A variety of gene mutations may predispose individuals to develop the disease but environmental factors such as measles virus likely play an important role.