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Paget’s Disease of Bone

Focal disorder of accelerated bone turnover: osteoclastic resorption followed by disorganized osteoblastic formation → enlarged, weak, vascular bone. Common sites: pelvis, spine, femur, tibia, skull; often polyostotic; usually age >55. Symptoms: bone pain, deformity (tibia/femur bowing), pathological fractures, skull enlargement, hearing loss; many asymptomatic. Labs: ↑ALP with normal Ca/PO4 (unless immobilization or hyperparathyroidism). Imaging: X‑ray with mixed lytic–sclerotic changes and bon...