Paget disease of bone - an update

Paget disease of bone is the most common metabolic bone disease after osteoporosis, affecting 2-4% of adults over 55 years of age. Its aetiology is only partly understood, but includes both genetic and environmental factors.

This article outlines the clinical features, diagnosis and management options for Paget disease of bone.

The disease may be asymptomatic, found incidentally on radiography or biochemistry, or present with bone pain, deformity, fracture or other complications. Bisphosphonate therapy is indicated for patients with symptomatic disease and should also be considered in patients whose sites of disease suggest a risk of complications, such as long bones, vertebrae or base of the skull. The treatment of choice is a single infusion of zoledronic acid; courses of oral alendronate (3-6 months) or risedronate (2 months) are also effective.