[Paget's disease of the skeleton]

Area of Science:

• Orthopedics
• Virology
• Pathology

Background:

• Paget's disease of bone is a chronic skeletal disorder characterized by increased bone turnover and structural abnormalities.
• It presents with localized manifestations, leading to thickened but mechanically weakened bones.
• Commonly affected sites include the pelvis, femora, tibiae, calvarium, and lumbar vertebrae.

Purpose of the Study:

• To provide a comprehensive overview of Paget's disease of bone, including its etiology, clinical presentation, diagnosis, and management.
• To discuss the current understanding of the disease as a slow virus infection of the skeleton.
• To outline treatment strategies and their efficacy, as well as the risk of malignant transformation.

Main Methods:

• Review of existing literature on Paget's disease of bone.
• Analysis of diagnostic methods including X-ray examination and bone scintigraphy.
• Evaluation of therapeutic interventions such as calcitonins and bisphosphonates.

Main Results:

• Paget's disease of bone exhibits localized areas of increased bone turnover with a characteristic mosaic pattern histologically.
• Diagnosis is primarily based on radiographic findings, with alkaline phosphatase levels indicating disease activity.
• Treatment with calcitonins and bisphosphonates effectively reduces alkaline phosphatase levels, with combination therapy offering more intensive management.

Conclusions:

• Paget's disease of bone is a slow viral skeletal disease requiring management for pain, deformities, and complications.
• Effective treatments include calcitonins and bisphosphonates, which help normalize alkaline phosphatase levels.
• Paget's sarcoma is a rare complication, and its prevention or delay through current therapies remains uncertain.