Abstract

SYSTEMATIC REVIEW OF PAGET’S DISEASE OF BONE

Arya Gigi*, Jojeena Ann and Bincy Varghese

ABSTRACT

Paget’s disease of bone is a common disorder characterized by increased but disorganized bone remodelling accompanied initially by an increase in osteoclastic bone resorption followed by a secondary increase in osteoblastic activity. Paget Disease of Bone (PDB) was first described by Sir James Paget in 1877 in a paper describing the clinical features of a disorder he called ‘osteitis deformans’. Some patients are asymptomatic but others present with bone pain or other complications such as broken bones, deformity, hearing loss and pinched nerves in your spine. Diagnosis is usually based on biochemical markers of bone turnover, radionuclide bone scan and radiological examination. Bisphosphonates, in particular zoledronic acid, are regarded as the treatment of choice for paget’s disease of bone. Major advances have been made in understanding the pathophysiology of paget’s disease in recent years and highly effective agents are now available which suppresses the abnormal bone turnover that causes the disease. Here we review recent advances in the epidemiology, pathogenesis, clinical features, prevention and management of paget’s disease and we also reflect upon the future challenges that remain to be overcome to explain the unusual distribution of the disease and to favourably alter the natural history and its complications.

Keywords: Paget’s disease, Bone resorption, Bisphosphonate, osteoclast.