Chapter 47 - Paget's Disease of Bone

Abstract

This chapter provides an introduction to Paget's disease of bone. It provides the etiology and pathogenesis of Paget's disease, and also provides the information related to the treatment of the disease. Paget's disease of bone is a chronic, localized disease, which can be monostotic or polyostotic. It is characterized by increased bone remodeling, bone hypertrophy, and abnormal bone structure. Patients may suffer from bone pain and deformity. Complications involve fractures, osteoarthritis, nerve compression syndromes, and neoplastic transformation. The disorder rarely occurs before the age of 40; thereafter, it is found with increasing prevalence with advancing age. The marked ethnic differences in the prevalence of Paget's disease of bone, coupled with strong evidence of familial aggregation and changes in incidence of the disease over the past 30 years indicate that genetic and environmental factors both contribute to the pathogenesis of Paget's disease. It is currently believed that, while genetic susceptibility clearly plays a critical role, there must be additional local factors that trigger, where and when Paget's disease occurs in individual patients.