[Paget's disease of bone]

Paget's disease of bone (PDB) is a chronic disorder of bone metabolism characterized by abnormalities of osteoclast function possibly based on the genetic background and slow viral infection. The symptoms of PDB are usually pain and deformity in involved bones and a subsequent increasing risk of pathological fractures, neurological complications and secondary malignant tumor development. The diagnosis of PDB is based on the clinical manifestations carefully examined, laboratory data such as measurement of serum alkaline phosphatase and characteristic findings of radiology including bone scintigraphy. The pathological examination also utilized for diagnosis of PDB in order to exclude bone metastases. Recently, the guidelines for diagnosis and management of PDB in Japan is proposed. According to these guidelines, etidronate and calcitonin are approved by government for treating PDB and surgical treatment are suggested to apply for orthopaedic problems in PDB. Also, rehabilitation is important for preventing the onset and worsening of de-conditioning secondary due to the complications of PDB.