title: Paget disease of bone. Diagnosis and indications for treatment.
abstract: BACKGROUND
  Paget disease was first described in 1877 by Sir James Paget. It is a focal disorder of bone remodelling, involving increased bone resorption and formation. The aetiology is uncertain but both environmental and genetic factors are thought to be involved in pathogenesis.
  
  
  OBJECTIVE
  This article outlines the clinical presentation, diagnosis and treatment of Paget disease.
  
  
  CONCLUSIONS
  Paget disease is associated with musculoskeletal pain, significant disability and impaired quality of life. Complications include pathological fracture, arthritis in adjacent joints, hearing loss, other neurological complications, heart failure and, rarely, osteosarcoma. Recent clinical trial data has demonstrated histological and radiological improvements in bone of patients treated with bisphosphonates. There is little data evaluating the long term effect of therapy on the risk of complications, however, restoration of normal bony architecture offers the prospect that complications related to deformity and increased bone fragility might be reduced by effective therapy.
authors.affiliation: University of Melbourne, Department of Clinical and Biomedical Sciences, Barwon Health, Geelong, Victoria. markk@BarwonHealth.org.au
authors.forename: M A
authors.initials: MA
authors.lastname: Kotowicz
mesh_terms: D000328:Adult; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010001:Osteitis Deformans / Q000150:complications / Q000175:diagnosis* / Q000628:therapy
chemical_list: D004164:Diphosphonates