Paget's disease is a bone condition that results in enlarged and deformed bones. It is a long-term condition. Any bone in the body can be affected. However, the most common sites are the spine, skull, pelvis, thighs, and lower legs.
Normal Bone Structure
Paget's disease is caused by a malfunction in bone formation. Normally, bones are constantly being broken down and rebuilt. With Paget's disease, bones are broken down abnormally fast, and new bone replacement is loose and bulky, instead of strong and compact. These poorly formed bones may become weak. They also may bend over time.
The exact cause of this bone malformation is unknown. Paget's disease may be triggered early in life by a viral infection.
Paget's disease is more common in people of Northern European descent and those who are 55 years of age and older.
Other factors that may increase your risk of Paget's disease include:
- Having a family history, especially in a parent, sibling, or child
Most people with Paget's disease don't have symptoms. For those with symptoms, Paget's disease may cause:
- Chronic bone pain, especially legs, hips, or spine
- Swelling or deformity of a limb
- Broken bones
- Bowing of a limb
- Damaged cartilage in the joints
Paget's disease that involves the skull may cause:
- Increased head size
- Facial pain
- Hearing loss
Paget's disease doesn't spread to other bones, but the symptoms do get worse over time.
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will order a blood test.
Imaging tests take pictures of internal body structures. These are done with:
It is best to begin treatment as soon as possible. Talk with your doctor about the best treatment plan for you.
Medications for Paget's disease include:
- Pain medications, such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs)
- Bisphosphonates to prevent the loss of bone mass
- Calcitonin to regulate calcium levels and assist in the bone building process
Surgery may be required if you have one of the following conditions:
- Bone fracture
- Severe degenerative arthritis
- Bone deformity
There are no current guidelines to prevent the onset of Paget's disease. People with primary family members who have Paget's disease are encouraged to have a blood test every 2-3 years after age 40.
NIH Osteoporosis and Related Bone Diseases National Resource Center
The Paget Foundation
The Arthritis Society
Albagha OM, Genetic Determinants of Paget's Disease (GDPD) Consortium. Genome-wide association identifies three new susceptibility loci for Paget's disease of bone. Nat Genet. 2011;43(7):685-689.
Michou L, Brown JP. Emerging strategies and therapies for treatment of Paget's disease of bone. Drug Des Devel Ther. 2011;5:225-239.
Paget disease of bone. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 26, 2014. Accessed June 22, 2015.
Schneider D, Hofmann MT, et al. Diagnosis and treatment of Paget's disease of bone. Am Fam Physician. 2002;15;65(10).
What is Paget's disease of bone? NIH Osteoporosis and Related Bone Diseases National Resource Center website. Available at: http://www.niams.nih.gov/Health_Info/Bone/Pagets/pagets_disease_ff.asp. Updated November 2014. Accessed June 22, 2015.
Last reviewed June 2015 by John C. Keel, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.