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Paget's Disease of Bone

Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Melissa Conrad Stöppler, MD

Paget's Disease of Bone and Osteoarthritis: Different Yet Related

Discover the differences between Paget's disease and osteoarthritis.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.

What is Paget's disease?

Paget's disease is a chronic bone condition characterized by disorder of the normal bone remodeling process. Normal bone has a synchronized relationship of mechanisms that act to lay down new bone and take up old bone. This relationship (referred to as 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 bone of adults. It's estimated that 1% of adults in the U.S. have Paget's disease. There is 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.

What are symptoms of Paget's disease?

Paget's disease commonly causes no symptoms and is 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 collar bone (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 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.



Next: How is Paget's disease diagnosed? »

Paget's Disease - Symptoms

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