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Osteitis Deformans (Paget Disease of Bone)

Christopher W. Bunt, MD, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Focal disorder of hyperactive bone resorption followed by excessive bone formation (remodeling) that is stimulated by abnormal osteoclasts

  • Results in enlarged, disorganized, weakened,...

DIAGNOSIS

HISTORY

  • Frequently asymptomatic (70–90% of patients); often noted as incidental finding (2)[B]

  • Resting or nocturnal bone pain is most common complaint.

  • Secondary osteoarthritis

  • Hearing loss (cra...

TREATMENT

GENERAL MEASURES

  • Shoe orthoses to counteract limb shortening

  • Hearing aids for severe sensorineural deafness

  • Rarely, splints for severely resorbed areas with high risk of fracture

MEDICATION

Goals...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Full activity to maintain function

  • Avoid excessive mechanical stress on involved bones.

Patient Monitoring

  • Follow-up visits every 2 to 4 months during drug therapy; ...

REFERENCES

1
Walker J. Pathogenesis, diagnosis and management of Paget's disease of the bone. Nurs Older People.  2014;26(8):32–38.  [View Abstract]
2
Singer FR, Bone HGIII, Hosking DJ, et al. Paget...

ADDITIONAL READING

  • Corral-Gudino L, Borao-Cengotita-Bengoa M, Del Pino-Montes J, et al. Epidemiology of Paget's disease of bone: a systematic review and meta-analysis of secular changes. Bone.  2...

SEE ALSO

Bone Tumor, Primary Malignant; Hyperparathyroidism; Osteoarthritis 

CODES

ICD10

  • M88.9 Osteitis deformans of unspecified bone

  • M88.88 Osteitis deformans of other bones

  • M88.1 Osteitis deformans of vertebrae

  • M88.0 Osteitis deformans of skull

  • M90.60 Osteitis deformans in neopla...

CLINICAL PEARLS

  • OD (Paget disease of bone) is often asymptomatic. When symptomatic, bone pain is the most common complaint.

  • Osteolysis and thickened bony cortices are common radiographic findings in OD...

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