Paget's Disease
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Introduction
Purposeless hyperturnover occurring in part of the bone. No one knows why this occurs.
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
Tends to begin in people over age 40, mainly in Caucasians.
There may be some connection with paramyxovirus.
Pathophysiology
A mosaic pattern occurs as the bone becomes structurally abnormal, with bits of hardened bone
Can result in changing bone shape or size, bome pain, pathologic fractures, kidney stones due to increased serum calcium, high output cardiac failure (dunno why), and neurologic syndromes.
Signs and Symptoms
- history
- physical exam
History
About 70% of people have mild or asymptomatic.
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Bone alkaline phosphatase can increase, as can serum calcium.
Diagnostic Imaging
The majority of cases are picked up throught imaging as asymptomatic disease.
Differential Diagnosis
Treatments
blocking osteoclasts using bisphosphonates or
Consequences and Course
sarcoma is a rare but almost always fatal result of Paget's disease.
Resources and References
Topic Development
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