Causes, symptoms and features of treatment of Paget's disease
Paget's Disease is a disease in which there is abnormal growth of bone of the skeleton and its distortion due to violations of patterns. This disease occurs in violation of the rehabilitation process in the bones, it is chronic. Otherwise this disease is called "deforming osteodystrophy" or "deforming ostos".
Most often the disease affects the Shin bone and spine, collarbone and skull, hip and shoulder bones. Suffer this disease entity 40 years and for the most part men, women – 50% less. Europe's population is the most susceptible to this disease.
causes of pathology
Medicine is not known the exact cause of this disease, however, there is an assumption that the following factors contribute to its occurrence:
- a variety of conditions leading to a violation of exchange of phosphorus and calcium in the body;
- the disease of viral nature;
- presence of virus in the body in the inactive phase;
- genetic predisposition.
Sometimes the cause of Paget's disease is a combination of all these reasons. If prevalent hereditary predisposition, the family members of the sick is desirable to take an x-ray examination of the bones and to monitor the levels of alkaline phosphatase by the blood test. a Special place in a number of viral causes of developing the disease given the virus measles.
How is Paget's disease?
Paget's Disease occurs in two forms: monoscale and paleosalinity. Manosalva form of the disease characterized by lesions of one bone, when paleosalinity the form of the strain exposed a few bones. The main difference of this disease from other diseases of the bones is that generalized lesions of bone is not observed – the disease affects exclusively the individual parts of the skeleton. Know what the bone disease is causing continuous process of changes in the bone tissue without affecting it any loads. It is believed that the disease can develop into a sarcoma of bone.
In the course of the disease goes through three stages:
- is inactive.
Initial osteolytic stage or characteristic peculiar certain areas of bone resorption, which at this place formed hollow fossa. During the active phase this process continues and at the same time is the overgrowth of bones – they begin to acquire cellular structure.
At the third stage – inactive – bone tissue is replaced by connective tissue, i.e. developed osteosclerosis. The bone surface becomes rough, due to thickening reduced mass. If you were struck bone, they bent and bent. With the defeat of disease of the bones of the skull marked their thickness up to 5 cm, this in turn entails a deformation of the face and head. In the case of bone lesions of the spine the spinal column is deformed and bent.
Onset of the disease occurs without any symptoms, asymptomatic for quite a long. The signs and symptoms appear gradually.
The First symptoms can be detected during examination of patients in other pathological States, i.e. learn about the disease only with blood tests when they accidentally revealed the change of the index responsible for the metabolism in bone tissue – phosphatase. In addition, a symptom of this disease is a deformity of the bones.
The Pain in the affected bones is the main symptom of the disease.
The Pain is usually continuous, dull and aching. Its peculiarity is that it does not abate after rest, and on the contrary increases alone. If the disease has occurred near the joint, the patient may complain of osteoarthritis. In addition, the inherent stiffness, joint mobility in the affected bone is limited.
With close and detailed examination in the lesions can be seen the swelling, the skin on this place changed – there is an individual parcel hyperthermia and redness. If the doctor will feel the affected area, you can celebrate the bones thickening and roughness of its edges. With a slight pressure on this bone it can be broken.
Due to the disease marked fragility of the bone tissue and the bone fractures even as a result of minor injury. With the defeat of the spine backbecomes misshapen, hunched. With bent legs and there is a wrong growth of the skull bones. Deformities of the bones of the skull and spine can cause loss of hearing or vision. This can occur as a result of squeezing deformed the bones of the nerve endings. For this reason, the patient may complain of constant headaches, numbness of the limbs and a feeling of "pins and needles" on the skin.
Methods of diagnosis
Diagnosis of the disease occurs according to the biochemical blood test and x-ray study of the bones of the skeleton. In the presence of the disease in the blood test results indicator enzyme alkaline phosphatase in serum will be higher than normal. The detection of such increase need regular blood tests to monitor possible changes.
x-ray examination is extremely reliable and informative method for the diagnosis of bone diseases.
In the picture in the presence of disease will include the following features:
- the bones of the skull is increased;
- the looseness of the structure of the bones;
- increased intracranial pressure
- increase in the size of tubular bones and pelvic;
- thickening of the periosteal layer;
- decay of bones and deformation;
Diagnosis of Paget's disease may be conducted using such methods as computed tomography and MRI. Their use is expedient only in cases where an x-ray was not found pathology. For diagnostic purposes also, the method of bone scan with technetium. It allows you to determine the foci of osseous tissue with pathological changes and to carry out dynamic observation of the disease under the influence of medical procedures.
While the disease has not shown itself in full force and asymptomatic, no treatment is required. Basically, the disease requires symptomatic treatment. If you have pain used analgesics and non-steroidal anti-inflammatory drugs stimulants (Diclofenac, Ibuprofen). In addition, we recommend the use of vitamin D and calcium.
If there is a change in gait caused by the deformation of the bones of the lower limbs, the doctor may recommend the use of orthopedic products. In some cases, the disease requires orthopedic surgery – arthroplasty or decompression. When a significant deformity of the hip may be replaced, as this will greatly improve the patient's quality of life and relieve him from the pain. This procedure is called arthroplasty. Treatment of Paget's disease includes also exercises with physical activity. Not recommended for a long time in bed, because at rest the pain increases.
Mandatory element of the therapy is the use of special medicines, the primary effect of which is aimed at slowing the process of destruction of bone tissue. It drugs – the bisphosphonates, their application should be lengthy. These drugs have their own side effects and therefore, their appointment should be carried out by a doctor.
opinion on the topic
so, a bone disease affecting mainly older people and is associated with impaired regeneration of bone tissue. Persons at risk for the development of Paget's disease should have regular checkups. The main symptoms are pain and deformity of bones.
Cure a disease, but it is possible to slow its course for a long time. The disease under the influence of treatment halts the progression, but the already existing pathological changes are irreversible. The duration of treatment is about six months and repeated as necessary.