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Paget's disease.

I Bertoldi1, L Cantarini, G Filippou

  • 1Centro per l'Osteoporosi e la Diagnosi Strumentale OsteoArticolare, Sezione di Reumatologia, Università di Siena. bertoldilaria@gmail.com.

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Paget's disease of bone, a common condition in adults over 55, has complex causes and can be asymptomatic. Early diagnosis and bisphosphonate therapy are key for managing symptoms and preventing complications.

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Area of Science:

  • Endocrinology
  • Orthopedics
  • Radiology

Background:

  • Paget's disease of bone is a prevalent metabolic bone disorder affecting over 55s.
  • Etiology involves genetic and environmental factors, with varied presentation from asymptomatic to severe complications.
  • Diagnosis relies on X-rays and alkaline phosphatase levels, though differential diagnosis with metastases is sometimes necessary.

Purpose of the Study:

  • To provide an overview of Paget's disease of bone.
  • To discuss diagnostic criteria and indicators of disease activity.
  • To outline current treatment and surgical management strategies.

Main Methods:

  • Literature review of Paget's disease of bone.
  • Analysis of diagnostic features and biochemical markers.
  • Summary of therapeutic interventions including bisphosphonates and surgery.

Main Results:

  • Paget's disease is common, often asymptomatic, and diagnosed via imaging and elevated alkaline phosphatase.
  • Plasma total alkaline phosphatase is a key indicator of disease activity.
  • Bisphosphonate therapy is recommended for symptomatic patients or those at risk of complications.

Conclusions:

  • Paget's disease requires careful diagnosis, considering its varied presentation.
  • Management focuses on bisphosphonate therapy for symptomatic or high-risk individuals.
  • Orthopedic surgery is primarily for fracture repair and arthroplasty in affected patients.