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
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.
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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? »