Ver el código de «Paget's disease of bone»

==Background==
*Characterized by areas of bone with excessive osteolytic activity and subsequent increased ostoblastic activity, resulting in disorganized bone formation
*Results in osteolytic lesions and weakened bone
*Eventually, affected bones may be abnormally enlarged
*Exact etiology unknown, likely genetic component
*Prevalence increases with age, more common in people of European descent
==Clinical Features==
*Initially asymptomatic or mild pain
*Bone pain at affected sites, often worse at night
*Pathologic [[fractures]]
*If skull involved, may report increased hat size, [[headache]], decreased hearing

==Differential Diagnosis==
*Bone tumor (e.g. [[osteosarcoma]] or metastesis)
*[[Multiple myeloma]], [[myelofibrosis]]
*Fibrous dysplasia
*Intramedullary osteosclerosis
*[[Sickle cell disease]]

{{Bone tumors and their mimics DDX}}

==Evaluation==
[[File:Paget's disease R coxal.jpg|thumb|Paget's disease of right innominate bone.]]
[[File:Pagets skull.jpg|thumb|Skull CT showing “cotton wool spots” typical of later stages of Paget’s disease.]]
*Imaging to evaluate for [[fractures]]
**Initial lesion may be destructive, radiolucent (especially in skull)
**Involved bones may be expanded, abnormally dense
**May have multiple fissure fractures in long bones
*Alk phos typically very high
*Serum calcium may be high

==Management==
*Treat [[fractures]]
*[[Pain control]]
*Bisphosphonates (e.g. Zoledronate) are treatment of choice for patients with severe symptoms or advanced disease

==Disposition==
*Discharge uncomplicated patients

==See Also==


==External Links==


==References==
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[[Category:Orthopedics]]