Education And Debate

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

BMJ 1996; 312 doi: (Published 24 February 1996) Cite this as: BMJ 1996;312:491
  1. David Hosking, consultant physiciana,
  2. Pierre J Meunier, professorb,
  3. Johann D Ringe, professorc,
  4. Jean-Yves Reginster, professord,
  5. Carlo Gennari, professore
  1. a City Hospital, Hucknall Road, Nottingham NG5 1PB
  2. b Service de Rhumatologie et de Pathologie Osseuse, Hopital Edouard Herriot, Lyon, France
  3. c Klinikum Leverkusen, University of Cologne, Leverkusen, Germany
  4. d Centre Universitaire d'Investigation du Metabolisme Osseux et du Cartilage Articulaire, Liege, Belgium
  5. e Instituto de Patologia Medica, Policlinico “Le Scotto,” Siena, Italy
  1. Correspondence to: Dr Hosking.


    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

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