Chapter 8 - Paget’s Disease of Bone: Prognosis and Complications

Abstract

Morbidity in Paget’s disease of bone (PDB), mostly related to skeletal and nonskeletal complications, results in an impairment of quality of life. The focal increases in bone turnover which characterizes PDB largely explain the pathogenesis of mechanical, vascular, and metabolic complications. The relative risk of mortality of patients with PDB was found to be increased in England and Wales, but not in the population-based inception cohort of Olmsted County (Minnesota, USA), the three most frequent causes of death being diseases of the circulatory system, cancers, and diseases of the respiratory system. Pain in pagetic bone is the only symptom of PDB for which there is firm evidence that therapy confers a clinical benefit, whereas pharmacological treatment to prevent future complications, such as osteoarthritis, fracture, or neurological complications, is more controversial. The most common complications of PDB are bone pain, bone deformity, fracture, neurological complications, headache, hearing loss, and osteoarthritis.