Paget's Disease of Bone and Osteoarthritis (cont.)

Distinguishing between Paget's disease and osteoarthritis

Not everyone with Paget's disease will develop osteoarthritis. Among those who have both, some may have osteoarthritis caused by the Paget's disease while others will simply have two unrelated conditions.

Both Paget's disease and osteoarthritis can cause joint and bone pain. In people with both conditions, joint and bone pain can occur in the same areas of the body. This can sometimes make it difficult for doctors to tell which condition is causing the pain.

No single test can diagnose osteoarthritis. The diagnosis of osteoarthritis in a person with Paget's disease may involve blood tests, x-ray images, or the examination of fluid drawn from the joint. Blood and urine tests may also be used to help find out if something other than Paget's disease is causing the arthritis.

The bone changes revealed by x-ray images help doctors diagnose both osteoarthritis and Paget's disease. However, in people who have both conditions in the same area of the body, it is often difficult to distinguish between the two. For this reason, the judgment of the patient's doctor is critically important for accurate diagnosis and effective treatment.

How does Paget's disease cause osteoarthritis?

Although they are different conditions, there is a link between Paget's disease and osteoarthritis. The changes that occur in bones affected by Paget's disease can also affect the function of nearby joints. As a result, people with Paget's disease frequently have osteoarthritis. Paget's disease can cause osteoarthritis when it:

  • changes the shape of bones under the cartilage of the joint

  • causes long bones (such as the thigh or leg) to bow and bend, placing excess stress on the joints

  • causes changes in the normal curvature of the spine

  • softens the pelvis, affecting the hip joint.

What are the available treatments?

The treatment strategies for Paget's disease and osteoarthritis are quite different, so it is important to distinguish between the two when making therapy-related decisions. For example, people with both disorders who get good results from their Paget's disease treatment may continue to experience osteoarthritis-related pain. Correctly identifying osteoarthritis as the source of pain is critical to the selection of effective treatments.

The goal of osteoarthritis therapy is to improve joint function and control pain and swelling. Treatment approaches include exercise, weight control, rest, joint care, prescription and over-the-counter medicines, pain relief techniques, and alternative therapies such as acupuncture and nutritional supplements. In certain cases, surgery on the affected joint may be needed.

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