Paget’s disease of bone

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Abstract

Paget’s disease of bone is an uncommon bone disorder with increased bone resorption and disorganized bone formation of woven bone. Its cause is unclear; there is a clear genetic component but additional environmental factors are important, given the reduction in severity and prevalence in the UK. Paget’s disease is usually asymptomatic and detected by an unexplained raised alkaline phosphatase on routine biochemistry. Symptoms include focal bone pain, including headache. Other symptoms include bone deformity and complications such as fracture and nerve conduction. Paget’s disease can sometimes present with immobilization-associated hypercalcaemia or high-output cardiac failure, and rarely can transform to an osteosarcoma. This chapter addresses the clinical features, diagnosis, and management of Paget’s disease of bone.