Definition of Osteitis deformans
Osteitis deformans: Better known today as Paget disease, this is a chronic bone disorder that typically results in enlarged, deformed bones due to excessive breakdown and formation of bone tissue that can cause bones to weaken and may result in bone pain, arthritis, bony deformities and fractures. The disease is named for an English surgeon, Sir James Paget (1814-1899).
Paget disease is rarely diagnosed in people under 40. Men and women are affected equally. Because Paget disease may be familial, after age 40, brothers, sisters and children of someone with Paget disease may wish to have an alkaline phosphatase blood test every 2 or 3 years to screen for Paget disease.
Many people do not know they have Paget disease because they have a mild case of the disease with no symptoms. Sometimes, symptoms may be confused with those of arthritis or other disorders. The symptoms of Paget disease can include:
Paget disease may be diagnosed using one or more of the following tests:
The outlook with Paget disease is generally good, particularly if treatment is given before major changes have occurred in the affected bones. Paget disease occurs most frequently in the spine, skull, pelvis, thighs, and lower legs. In general, symptoms progress slowly, and the disease does not spread to normal bones. Treatment can control Paget disease and lessen symptoms but is not a cure.
Paget's disease may lead to other medical conditions, including:
Paget disease is NOT associated specifically with osteoporosis. Although Paget disease and osteoporosis can occur in one and the same person, they are completely different disorders. But, despite their marked differences, many treatments for Paget disease can also be used to treat osteoporosis.
The goal of drug treatment is to control Paget disease activity for as long a period of time as possible. Treatment options include aspirin, other anti-inflammatory medications, pain medications, and medications that slow the rate of bone turnover, such as calcitonin (Calcimar, Miacalcin) and the bisphosphonates including etidronate (Didronel), alendronate (Fosamax), pamidronate (Aredia), tiludronate (Skelid), and risedronate (Actonel).
There are generally three major complications of Paget disease for which surgery may be recommended.
Complications resulting from enlargement of the skull or spine may injure the nervous system. However, most neurologic symptoms, even those that are moderately severe, can be treated with medication and do not require neurosurgery.
In general, people with Paget's disease should receive 1000-1500 mg of calcium, adequate sunshine, and at least 400 units of vitamin D daily. This is especially important in patients being treated with bisphosphonates. Patients with a history of kidney stones should discuss calcium and vitamin D intake with their physician.
Exercise is very important in maintaining skeletal health, avoiding weight gain, and maintaining joint mobility. Since undue stress on affected bones should be avoided, patients should discuss any exercise program with their physician before beginning.
Last Editorial Review: 8/28/2013
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