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Paget's disease (complications (hearing loss (sensorineural,…
Paget's disease
complications
pathological fractures
OA
hearing loss
sensorineural
conductive
neural compression
secondary development of tumours
high output congestive cardiac failue
hyperparathyroidism
extramedullary haematopoesis
pathophysiology
lytic stage (incipient active)
predominated by osteoclastic activity
mixed (active)
osteoblastic as well as osteoclastic
sclerotic/blastic (late inactive)
sites of involvement
spine
pelvis
skull
petrous temporal bone
proximal long bones
ancillary
ALP elevated
N Ca and Phosphorus
urine hydroxyproline increased
MRI
incidence
relatively common
4% over 40
M=F
clinical
history
3/4 asymptomatic
localised pain and tenderness
increased focal temp due to hyperaemia
increased bone size
exam
bowing deformities
kyphosis
decreased ROM
conductive hearing loss
pathological fractures
treatment
medical
bisphosphonates
analgesics
NSAIDs
surgical
ORIF
prognosis
good
polyostotic have poorer prognosis c.f. monostotic
higher risk of complications
definition
chronic bone disorder characterised by excessive abnormal bone remodellling
aetiology
?
disease of osteoclasts
viral
genetic
diagnosis
xray
flame/blade of grass sign in long bones