musculoskeletal and connective tissue disorders
Paget Disease of Bone
Symptoms and Signs of Paget Disease of Bone
Paget disease of the bone is usually asymptomatic. If symptoms occur, they develop insidiously, with pain, stiffness, fatigue, and bone deformity. Bone pain is aching, deep, and occasionally severe, sometimes worse at night. Pain also may arise from compression neuropathy or osteoarthritis. If the skull is involved, signs may include skull enlargement bitemporally and frontally (frontal bossing), dilated scalp veins, and nerve deafness in one or both ears. Symptoms may include vertigo, headaches, and hearing impairment. Deformities may develop from bowing of the long bones or osteoarthritis. Pathologic fractures may be the presenting manifestation. New onset or severe pain at a site of pagetic bone should prompt consideration of osteosarcoma. The most common complication of Paget disease of bone is Osteoarthritis (OA) None Osteoarthritis occurs in up to 50% of patients and develops in joints adjacent to involved bone. Pathologic fracture is also common due to focal areas of weakened bone. Overgrown bone may compress nerves and other structures passing through small foramina. Lumbar Spinal Stenosis or Rare complications include transformation to Osteosarcoma (osteogenic sarcoma) in < 1% of patients. Highly vascular bones may bleed excessively during orthopedic surgery. Very rarely, 