Paget's disease: diagnosis, treatment and prevention

Archaeologists have found characteristic changes in the bones of Neanderthals in the burials of American Indians and in the studies of the skeletons of the mummies of Ancient Egypt. Most often this disease is noted in countries where there are many English people (Great Britain, New Zealand, Australia).

Statistics from the XIX century show that a genetic predisposition to Paget's disease is present in 15% of patients, and it occurs twice as often in men.

The disease is also known as deforming osteitis or deforming osteodystrophy. As the name implies, this disease causes deformation of the skeleton.

Bone masses are a dynamic system, they are in an endless process of remodeling - destruction and restoration of living bone tissues, replacement of old cells with new ones. The skeleton contains the stores of calcium, phosphate and magnesium, which the body, if necessary, flushes to its needs.

When the regeneration process is broken, renewal of bones ceases, their structure becomes loose, young tissues do not appear. In the skeleton, weaknesses are noted - deformed bones that have a mosaic structure, are too elongated and curved, fragile and easily broken, not fulfilling the supporting function.

Similar defects can occur anywhere in the skeleton, the process is usually not limited to one bone. Among others, pelvic bone, spinal column, tubular limb bones and skull suffer from pathology.

Causes of the disease

The causes of this type of bone damage are still unknown.Modern medicine puts forward the following versions of the causes of the disease:

1. There are assumptions about a slow viral infection that has been dormant for many years in the body, and then some provoking factors gives impetus to its development, for example, the transferred measles is considered one of the main pathogens disease.
2. Because of genetic predisposition - this is a "family" disease, so close relatives of a person who has fallen ill once a year should do an x-ray of the bones and a blood test for biochemical indicators to track the level of alkaline phosphatase.
3. For various reasons, phosphorus-calcium metabolism is disrupted.
4. A combination of several provoking factors is possible, as a result of which a dystrophic process occurs.

Symptoms

Defects of bone tissue with this lesion are specific. Tubular bones curved, become rough, thick, but much easier, since their structure is transformed into a porous one. When the disease of the skull bones they thicken to 5 cm, the head loses its shape, and the face deforms.

Depending on the extent of the lesion and the type of diseased bone, Paget's disease has differentsymptoms:

1. The onset of the disease is noted from the zone around the joint with simultaneous defeat.
2. The pain in the affected areas is constant, dull or aching, not passing after rest.
3. The mobility of the affected joint is limited.
4. It is possible to feel changes in the form of a bone, near the joint of its edge become thick and as if broken off, uneven.
5. It is easy to develop fractures, even from a weak effect.
6. The legs suddenly become curved, even in adults - one or both have an X-shaped or O-shaped deformation.
7. The back hurts, there is a stoop.
8. Deformed face and skull.
9. There are pains, characteristic for neuritis, due to compression of nerve endings between deformed vertebrae.
10. There are serious problems with hearing and sight, there are severe headaches due to deforming rearrangement of the temporal bones.
11. With deformation of the spine, the damage to his nerves causes numbness and tingling in the limbs, the patient feels that the body is constantly "creepy."
12. Violated motor functions of the joints of the affected limbs, spine, pelvic and shoulder girdles.
13. Pain in the lower extremities is much more pronounced than in the upper extremities, since its degree depends on the load on the affected area.
14. The resulting fractures quickly grow together, as the broken bone is replaced by a connective bone.
15. In case of severe damage, cardiac arrest or bone loss in sarcoma may occur.

The treatment of Paget's disease

If this disease is suspected, you should contact an orthopedic doctor. Methods of treatment are aimed at stabilizing the state of bones, reducing the activity of the disease and preventing complications.

Bisphosphonates

Increasingly with the disease resorted to treatment with bisphosphonates. These are very effective remedies, although they can not cure the disease, but provide a stable remission for a long time.

Bisphosphonate preparations prevent loss of calcium by bone tissue, increase the mineralization of the skeleton, reduce the risk of fractures. They can be taken in the form of injections, tablets, in liquid form. The patient can choose how to take them - once a day, a month or as an intravenous infusion once a year.

There are contraindications for people with gastrointestinal diseases, since the medicine is digested hard, only 1% of all the necessary substances.

Non-steroidal anti-inflammatory drugs

To relieve pain, non-steroidal anti-inflammatory drugs are used, for example,paracetamol, diclofenac, ibuprofen.

Calcium preparations

Calcium preparations help to restore its balance after washing out of the bone mass. They stop the pathological process of bone destruction a little.

They should be taken together withvitamin D, without which calcium is not absorbed by the body. It is best to use vitamin-mineral complexes, as they give additional doses of potassium, magnesium, phosphorus.

Endoprosthetics of joints

When the patient has fractures, it is necessary to resort to arthroplasty of joints (their replacement with an artificial component) and installation of structures to strengthen the fragile bone.

In the case of severe curvature, a corrective osteotomy is applied, in which the deformation of the bone is eliminated by excision of defective areas and its connection in the correct form by means of special adaptations.

Complications of Paget's Disease

This is a serious disease, and its consequences are also very dangerous:

1. Frequent fractures with impaired motor function.
2. Blindness and deafness due to pathological processes in the bones of the skull.
3. Disability due to irreversible curvature and destruction of bones.
4. The development of sarcoma around the affected joint.
5. Strong cosmetic defects - the effects of Paget's disease can be seen in the photo. They look awesome - crooked legs, hunched back, deformed head.

Prevention of disease

If the family has a disease of this species, the relatives of the sick should be protected from viral infections that can provoke the development of defects in bone tissue. People over the age of 40 should undergo a regular medical examination in order to prevent the development of pathological processes.

If a diagnosis was made - Paget's disease, then to maintain the health of the remaining bones and rescue the motor functions of the joints, one must constantly be observed at the orthopedist traumatologist.