In Paget’s disease, a normal system of health maintenance and bone strength is disturbed, and new bone is created faster than the old one breaks down. The disease occurs in two stages. In the first, “vascular” stage, bone tissue breaks down, but the remaining areas are filled with blood vessels and fibrous tissue, and not with the new, strong bone. In a second, “sclerotic” stage, blood-filled fibrous tissue hardens and resembles bone tissue, but this bone is weaker and more fragile than the healthy bone.
Localization of Paget’s disease is very diverse. It can capture part of the bone, an entire bone, or many bones. It most commonly occurs in the pelvis and the thorax (tibia). It often affects the thigh bone, skull, spine and collarbone. The cause of the disease is unknown.
Paget’s disease is not always accompanied by symptoms but, if they appaer, those are usually strong pains in the bones. The disturbances are virtually persistent, and often get worse at night. Affected bones are increased and deformed, and there is a feeling of heat and pain in the bones.
In the advanced phase of the disease the legs can bend, the skull deforms, and on the spine can develop the postural curve.
In Britain, one in every 100 people over the age of 50 has Paget’s disease; however, the illness causes problems in only 10% of the patients.
What is surprisingly is the fact that this disease is quite geographically widespread. For example, it is very rare in Norway, Japan and South Africa. It is more common in the UK, especially in northern England. The importance of this uneven distribution has not yet been explained.
Bones weakened by Paget’s disease are prone to a break. In some rare cases, skull bone obstruction due to Paget’s disease may squeeze the auditory nerve that passes through the skull and cause deafness. Another possible danger is the decompensation (failure) of the heart, because the heart is overloaded because of a significantly increased blood flow through the diseased bone. In rare cases, bone tumors may develop.
What to do?
If you think you have a Paget’s disease, contact a doctor who will probably refer you to X-rays and various blood tests after your examination, which will allow him to set up a solid diagnosis.
For now, Paget’s disease is incurable, but the main symptom – pain – can be alleviated by analgesics (e.g. paracetamol). If the pain is severe, your doctor may recommend regular hormone injections, calcitonin, which is naturally creating in parathyroid glands. Additional calcitonin reduces pain, but occasionally some patients experience an allergic reaction to injections and other nausea. In this case, stronger analgesics are usually prescribed.