Signs and symptoms of Paget disease

The signs and symptoms of the Paget disease mainly depend on the part of the body that has been affected.  The fact that the disease affects four main parts of the bones in the human body which include: Pelvis, spine and Leg. In general, the Paget disease of the pelvis bone normally causes the hip pain to the patients, the overgrowth of the skull bone may cause headaches and hearing problems and if the spine bone is affected by the disease it may result into the nerves around the spine being compressed hence cause the pain around the spine (Brunner & Smeltzer, 2010). As a matter of fact, there are no specific signs and symptoms of Paget disease but the disease I normally detected incidentally through X-ray tests which might be conducted to a patient or patients for other reasons. Nevertheless, the only known signs and symptoms of the Paget disease is complaint of pain from a specific part of the bone in the body.  As the bones weaken and bend, they make the patient to be bowlegged if the legs were affected by the disease.  The misshaped and enlarged bones of the patients’ legs might result into extra stress and pressure upon the nearby joint which might cause hip or knee osteoarthritis.

The fact that the disease causes the body to generate new bone faster than the normal rate, the hasty remodeling and production of weaker and softer bones in the body results into fractures and deformities which causes the patient to experience pain during the process.  In the recent time, there have been increased cases of Paget disease. Therefore, the patients who have been affected by disease are much likely to develop congestive heart failure as a result of the increased heart workload. Whenever a patient experience pain in the joints and the various bone parts in the body, weakness and tingling and bone deformities it is appropriate advice from the doctors and test for the Paget disease because these are the major signs and symptoms of the disease. Most scientists believe that the symptoms and signs of Paget disease are unknown because the disease is suspected to result from genetic and environmental combination factors.  Hence, the scientists have linked several genes to be the cause of the disease hence making it hard for the disease to have specific signs and symptoms (Petit & Adamec, 2005). While determining the symptoms and signs of the Paget disease, it is important for the patients and the society to put into consideration the family history of being affected by the disease. In addition the nationality of a person may influence a person from being infected by the disease. Patients from countries such as Asia, Scandinavia, Scotland, England and Greece are more likely to be affected by the disease than people from other countries. Other factors which might influence the signs and symptoms of the Paget disease may include: sex and age.

Modalities

Someone with Paget’s disease may go into their primary Doctor complaining of joint or bone pain. The first step the doctor would take is order x-rays for the very section of the body that the patient is complaining about and also retrieves blood. From there a Rheumatologist or practitioner who primarily focuses on bone disorders cans diagnosis the patient with Paget’s disease.  Blood work indicates if there are elevated levels of alkaline phosphatase. X-Ray images show areas of bone reabsorption, enlargement of bone, and deformities (Altman, 2015). Although x-rays are the first images used to diagnose the patient, it is not the considered the best modality to see the extent of the disease. Nuclear medicine injects radioactive material that highlights the areas of the bone that are affected by Paget’s disease. CT demonstrates cross-sectional images of complex structures such as spine and skull to show the extent of calcification. Although MRI might not be a modality used in the first steps of diagnosing this disease, it can be helpful later down the road. MRI shows alterations in bone marrow where it is replaced with fatty deposit.

Rare complications of Paget’s disease include heart failure. Paget’s disease causes increase blood flow to the bones which causes difficulty for the heart to keep up with the demand for increase blood flow.  Bone cancer such as osteogenic sarcoma causes severe bone pain and swelling of tissue around the bone (Hamilton, 2013). Also, people with Paget disease often develop kidney stones and calcium deposits in blood vessels and heart valves. These problems are caused by increase calcium in the body from the breakdown of bone tissue. Hyperparathyroidism is also a rare complication that people may develop with Paget’s disease.

Paget Disease Treatment

The Paget disease treatment is directed towards management and controlling of the disease activity complications. When the blood testing and symptoms of the Paget disease show low level of the serum alkaline phosphate there may be no or minimum treatment of the disease which might be required (Cripe, 2016).  Whenever a patient suffering from Paget disease may experience bone pain, the doctor may be required to offer pain relieving medications and anti-inflammatory drugs. The specialized footwear and heel lifts may be used by the patients suffering from the bone deformity in order to assists in the support of the deformed bones.

Moreover, specialized surgical operations might be administered by the doctor to the Paget disease patient suffering from severe bone deformation, fractures, damaged joints and pinched nerves. Prior to the patient suffering from the Paget disease undergoing the surgical operation it is important to try other forms of treatment using Bisphosphonates in order to reduce the surgical complications and risks such as over bleeding.

The medical treatment of the Paget bone disease may involve either injectable calcitonin or Bisphosphonates medication. The specific drugs are used in treatment of the patients suffering from Osteoporosis. The Bisphosphonates such as the Skelid, Didronel, Actonel and Fasamax are mainly administered through the mouth. They are supposed to be take early in the morning before the patient takes his or her breakfast with eight ounces of water. The Bisphosphonates are believed to cause the esophagus and stomach irritation. Nevertheless, the Intravenous Bisphosphonates are believed to cause joint and temporary muscle pain bust are not characterized by esophagus and stomach irritation (Lescher, 2011). As a matter of fact, the mode of treatment of a patient suffering from a Paget bone disease may depend on the severity and the condition of the patient.  It is believed that, there are patients who are allergic to some medicine and it is the role of the doctor or physician offering Paget disease treatment to make decision in regard to the best treatment mode which best suits the patient.  Depending of the patient’s nationality, age, gender and family history, the physician may be advised on the best treatment mode which might lead to the patient’s healing.