Fortnightly Review: Paget's disease of bone: diagnosis and management

doi:10.1136/bmj.312.7029.491

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David Hosking, consultant physiciana,
Pierre J Meunier, professorb,
Johann D Ringe, professorc,
Jean-Yves Reginster, professord,
Carlo Gennari, professore

^a City Hospital, Hucknall Road, Nottingham NG5 1PB
^b Service de Rhumatologie et de Pathologie Osseuse, Hopital Edouard Herriot, Lyon, France
^c Klinikum Leverkusen, University of Cologne, Leverkusen, Germany
^d Centre Universitaire d'Investigation du Metabolisme Osseux et du Cartilage Articulaire, Liege, Belgium
^e Instituto de Patologia Medica, Policlinico “Le Scotto,” Siena, Italy

Correspondence to: Dr Hosking.

Abstract

Summary points

Paget's disease is a localised monostotic or polyostotic progressive bone disease of uncertain origin (it may be caused by a slow viral infection)
It is characterised by increased bone remodelling, leading to pain, fractures, and deformities with the risk of skeletal, articular, or neurological complications
Radiography, scintigraphy, and bone biochemistry are useful tools in achieving a positive diagnosis
The primary aim of treatment is to reduce pain and the risk of developing long term complications
Potent antiresorptive drugs are now available which control the increased bone remodelling and have led to a dramatic improvement in treatment