Paget's disease - a chronic disease of the bone, which is most common among the elderly. It develops in about 3-4% of people over fifty years. People younger than 40 years of Paget's disease is rare. It is slightly more common in men than women.
This disease can affect any bone in the skeleton, but most commonly affects the spine, femur, the long bone in the limbs and skull. It can affect one or more bones of the bones and all the bone completely.
Paget's disease is inherited. It can occur in 25-40% of relatives of patients with this diagnosis. Some doctors believe that its development is influenced not only by genetics, but also the environment, but it is not yet proven.
In the normal bone remodeling process takes place on a daily basis. Some cells are absorbed other are generated in response to a load which is subjected to the skeleton. Cells which absorb the bone, called osteoclasts; cells that form new bone tissue - osteoblasts.
Paget's disease osteoclasts are more active than osteoblasts, and therefore, the absorption rate exceeds bone. Osteoblasts are trying to meet the increased requirements, resulting in their work becomes chaotic. The new bone produced abnormally large, misshapen and not well fit together. Normal bone adjacent to each other like bricks in a well-built wall, and Paget's disease, they begin to resemble a chaotic mosaic like bricks laid as necessary. Bone such a patient large and dense but, nevertheless, weak and fragile.
Paget's disease often occurs without any symptoms. The doctor may notice signs of disease on x-ray made in another context, or in the results of blood tests
Blood tests: a mirror of health
(in Paget's disease shows an increased level of alkaline phosphatase in blood serum). Patients who have symptoms, the most common complaint is pain in the bones. This pain may be associated with active Paget's disease or its complications, including:
- Fractures and cracks in small bones;
- Bone deformities;
- Progressive arthritis
Arthritis - a variety of forms and complications
in the joint adjacent to the affected bone;
- Compression of nerves near the increased bone, which leads to loss of sensation and mobility.
Symptoms may also be associated with the disease will affect the level of calcium in the blood. When Paget's disease affects several bone osteoclast activity may increase the level of calcium in the blood. This rare complication might cause fatigue, weakness, loss of appetite, abdominal pain, or constipation
Constipation - Watch out for food
Very strong and relentless course of time under the influence of drugs or pain in the area where the affected bone Paget's disease may indicate that the disease has developed cancer in bone. Sarcoma occurs in approximately 1% of patients with Paget's disease, and these patients are usually older than 70 years. This type of bone tumor is very aggressive and the prognosis is usually unfavorable. None of the treatments used in Paget's disease affects the risk of developing Kaposi.
Treatment surgical methods
Drug treatment can reduce the symptoms of Paget's disease, but at this time there is no known way to reverse the effect of wrap disease on bone.
Patients who have no symptoms, no treatment is required; medical care is limited to observation. So, it is recommended to make regular x-rays to detect any changes. If a patient is suffering from mild to moderate pain, are very useful nonsteroidal antiinflammatory drugs and aspirin.
If Paget's disease affected thigh or leg, using sticks while walking can significantly alleviate the pain. Furthermore, stick helps prevent falls, and at the same time reducing the risk of fractures. Sometimes, to prevent displacement of the bones, used bandages.
When severe pain in the bones used drugs from the group of bisphosphonates, blocking osteoclasts. At the time of their admission should periodically check the level of alkaline phosphatase in the blood, since this figure will steadily decrease, along with pain in the bones.
Treatment of surgical techniques
Surgical techniques are used mainly for the treatment of Paget's disease complications. It may be necessary for fractures, displaced bones and severe arthritis. Surgery may also be assigned, if you increase the bone begins to put pressure on the nerves, especially in the spine or skull. If Paget's disease develops in sarcoma
Sarcoma - a full recovery possible
In most cases attempt to remove the tumor.
The procedures used for the treatment of fractures, arthritis or offset bone in patients with Paget's disease are similar to those applied in the treatment of the same conditions in humans since, in general, healthy bone. However, as in the Paget's disease increases the flow of blood to the bones, the doctor may recommend a bisphosphonate before operatsitsey to reduce the possibility of blood loss.
Bones affected by Paget's disease, restored longer than healthy bones, so the period of rehabilitation patients usually take longer.