Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
Paget's Disease of Bone and Osteoarthritis: Different Yet Related
Paget's disease and osteoarthritis are completely different disorders that share some of
the same symptoms; namely, joint and bone pain. This fact sheet describes the
differences between Paget's disease of bone and osteoarthritis, the similarities
in their symptoms, how Paget's disease can cause osteoarthritis, and issues
related to diagnosis and treatment.
What is Paget's disease?
Paget's disease is a chronic disorder that can
result in enlarged and misshapen bones. The excessive breakdown and formation of
bone tissue causes affected bone to weaken, resulting in pain, misshapen bones,
fractures, and other bone and joint problems, including osteoarthritis. Paget's
disease typically is localized, affecting just one or a few bones, as opposed to
osteoporosis, for example, which affects all the bones in the body. Scientists
do not know for sure what causes Paget's disease.
What is osteoarthritis?
Osteoarthritis is a condition that causes changes in
cartilage, the elastic tissue that cushions the joints. Healthy cartilage allows
bones to glide over one another, while absorbing energy from the shock of
physical movement. In osteoarthritis, the surface layer of cartilage breaks down
and wears away. This allows bones under the cartilage to rub together, causing
pain, swelling, and loss of motion of the joint.
Paget's disease is a chronic condition of bone characterized by disorder of the normal bone remodeling process. Normal bone has a balance of forces that act to lay down new bone and take up old bone. This relationship (referred to as "bone remodeling") is essential for maintaining the normal calcium levels in our blood. In bone affected by Paget's disease, the bone remodeling is disturbed and not synchronized. As a result, the bone that is formed is abnormal, enlarged, not as dense, brittle, and prone to breakage (fracture).
Paget's disease affects older skeletal bone of adults. It's estimated that 1% of adults in the U.S. have Paget's disease. There is also
an extremely rare form of Paget's
disease in children, referred to as juvenile Paget's disease. Paget's disease is
also known as osteitis deformans.
What causes Paget's disease?
It is not known what causes Paget's disease. Recently, certain genes have been associated with Paget's disease, including the Sequestrosome 1 gene on chromosome 5. Virus infection may be necessary to trigger Paget's disease in people who have inherited the genetic tendency to develop the condition by having these genes.
What are Paget's disease symptoms?
Paget's disease commonly causes no symptoms and is often incidentally noted when
X-ray tests are obtained for other reasons. However, Paget's disease can cause
bone pain, deformity, fracture, and arthritis. The bone pain of Paget's disease
is located in the affected bone. The most common bones affected by Paget's
disease include the spine, the thigh bone (femur), the pelvis, the skull, the
collarbone (clavicle), and the upper arm bone (humerus).
The symptoms of Paget's disease depend on the bones affected and the severity
of the disease. Enlarged bones can pinch adjacent nerves, causing tingling
and numbness. Bowing of the legs can occur. Hip or knee involvement can lead to
arthritis,
limping, as well as pain and stiffness of the hip or knee. Headache, loss of
vision, and hearing loss can occur when bones of the skull are affected. With
very widespread Paget's disease, it is possible to develop congestive heart
failure due to an increased workload on the heart.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Cauda equina syndrome is a medical emergency condition that is caused by the uncommon compression of the nerves at the end of the spinal cord. Symptoms of cauda equina syndrome include lower back pain, tingling and/or numbness in the buttocks and lower extremities, bowel or bladder incontinence, and weakness in the legs. Causes of cauda equina syndrome include herniated discs, hematomas, or infection. Treatment is generally prompt surgery.
Blindness is the state of being sightless. Causes of blindness include macular degeneration, stroke, cataract, glaucoma, infection and trauma. Symptoms and signs may include eye pain, eye discharge, or the cornea or pupil turning white. Treatment of blindness depends upon the cause of the blindness.
Hearing loss (deafness) may be present at birth or it may manifest later in life. Deafness may be genetic or due to damage from noise. Treatment of deafness depends upon its cause.
Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where
two different bones meet. A joint functions to move the body parts connected by its bones.
Arthritis literally means inflammation of one or more joints.
Arthritis is frequently accompanied by joint pain. Joint pain is
referred to as arthralgia.
There are many types of arthritis (over 100 identified, and the number is growing). The types range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness in the United States.
The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), metabolic abnormalities (such as gout and pseudogout), hereditary facto...
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